Texas Workforce Commission Program

Thank you for applying to volunteer at Harris Health System!

The objective of this Harris Health-TWC collaboration is to provide area residents with the opportunity to develop and enhance their job skills while gaining valuable, real life work experience to improve their employment prospects.

In-Person Program Requirements:

1. Some online training required
2. Full medical clearance:

MMR, Varicella, TDAP - Harris Health does NOT provide
Flu shot - Harris Health can provide
Covid shot - Harris Health can provide
TB Titer - All participants must make an appointment in our Occupational Health Clinic to get this titer
ALL ARE REQUIRED

3) Onsite training, medical clearance, and badging appointments

4) Must have excellent customer service skills

5) Scheduled days and hours determined by needs of the host department

If you have any additional questions or concerns, please contact your TWC counselor.

Thank you for your interest in volunteering at Harris Health System!

New User Details

User ID

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Password

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I am applying for an 'In-Person' Placement at Harris Health

By clicking "YES" to be considered for an In-Person placement at Harris Health, you are agreeing to the following:
*You will be able to complete some online training
*You will provide proof of the following immunizations:MMR, VARICELLA, TDAP, COVID, and FLU (September - March)
*You will come in person to the Occupational Health Clinic to receive a TB Titer, onsite training, and to get a badge

____________________________________________________________________________________________________

Please use the space below to let us know any challenges you have meeting the minimum requirements for either virtual or in person opportunities.

VOLUNTEER INFORMATION

Gender

Name prefix

* First Name

* Last Name

* Date of Birth

* Home Address

* City

* State

* Zip Code

* Primary Phone

* E-mail Address

* Drivers License

* State Issued

* Social Security Number

Language

Additional languages

Ethnicity

Marital Status

Wheelchair/requires handicap access

What reasonable accommodations might you need in order to work in this placement?

EMERGENCY CONTACT INFORMATION

* Primary Contact Name (First,Last)

* Relationship

* Primary Phone

* E-mail

Home Address

City

State

Zip Code

EDUCATION AND EMPLOYMENT INFORMATION

Highest Level of Education

School/Major:

Business Experience

Please list any previous volunteer experience:

TWC SHORT ANSWER

* Please describe yourself in five words or less (Ex. Independent thinker, reliable, etc).

PHOTO RELEASE:

As a Harris Health volunteer, I realize that my image may be taken at hospital celebrations and other media events. I give my permission to the Harris Health System Director of Volunteer & Guest Services and the Administrative Director of Corporate Communications to use my image in any appropriate and related materials that will promote or otherwise publicize the Volunteer & Guest Services department or Harris Health.*

BACKGROUND CHECK AUTHORIZATION:

* I authorize Harris Health System to conduct any and all inquiries necessary to determine my acceptability as a volunteer, including a thorough background check. I understand that this background check may include verification of personal and/or employment references, military information or police record inquiries.

* I am 18 years of age or older.

* By checking this box I agree to have Harris Health System conduct a background check.

Please Select

Choose if you have ever been convicted of or been on deferred adjudication for, or are you now either awaiting trial for or on deferred adjudication for, a felony or misdemeanor.

List and explain convictions if any:

CONFIDENTIALITY AGREEMENT:

I agree to use confidential or proprietary information only as needed to perform my volunteer duties. This means I will not access confidential or proprietary information without legitimate need/permission, nor in any way divulge, copy, release, sell, lend, revise, alter, or destroy any confidential or proprietary information belonging to Harris Health System. I understand that I will be automatically dismissed as a volunteer if I do not respect my responsibility for maintaining confidentiality.

If accepted as a Harris Health System Volunteer, I agree to the following:

* 1. Understand that it is a crime to solicit business for attorneys and/or insurance companies.

* 2. Am donating my services to the hospital district without expectation of compensation and am not to solicit employment while performing my volunteer duties.

* 3. Understand that the Volunteeer & Guest Services Department does not assign volunteers to areas of professional or medical confilicts of interest.

* 4. Will not sell or attempt to sell any goods or services, solicit monetary or in-kind contributions, or collect/distribute petition signatures on Harris Health System premises.

* 5. Understand that, I must never attempt to assess or diagnose any patients, nor shall I attempt to perform any medical procedures (i.e. draw blood, insert an IV and any other procedure that requires a medical license) on patients.

* 6. Understand that, I will be evaluated by the Volunteer & Guest Services Department , as well as, the department in which I have been placed. I also will be given the opportunity to evaluate the deparment and the volunteer duties that I have been assigned.

* 7. Understand that the Volunteer & Guest Services Department reserves that right to terminate my volunteer status as a result of: Failure to comply with Harris Health System, as well as, departmental policies, rules and regulations. , Unsatisfactory attitude, work or appearance/attire,Habitual tardiness and/or absences, Any behavior deemed unacceptable by any Harris Health System facility, department supervisor and/or the Volunteer & Guest Services Department.

* I HAVE READ ALL THE ABOVE STATEMENTS AND I AGREE TO ADHERE TO THEM

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