Clinical Volunteer Registration is Full.

VOLUNTEER GUIDELINES

I agree to abide by these guidelines:
• The sacredness of life and the dignity of each guest, volunteer, and leader.
• The confidentiality of each guests’ protected health information.
• A safe medical setting: I will not perform, advise, or offer counseling outside of my scope of licensing, certification, or delegated responsibility.
• The safety of each guest and volunteer. I will report any high risk issues such as suspected abuse, crime, human or drug trafficking to a clinic leader.
• An attitude of love and compassion toward each guest, volunteer, and leader.

VOLUNTEER STATEMENT OF CONFIDENTIALITY
As a volunteer at a Compassion Clinic, I understand and agree to the following principles of confidentiality outlined below:
During and following my service with the clinic, and any information about patients (guests) who call this clinic, are seen at this clinic, or who have medical records in this clinic must be kept strictly confidential. Information must at no time be discussed outside of the clinic unless the patient has specifically authorized the transfer of medical information, or a provider in this clinic is conferring with outside providers in caring for the patient. Caring for the patient includes personal interaction, treatment, consultation, or intervention based on a “need to know” basis.
I agree to conduct myself in a manner that assures patient confidentiality during discussions that pertain to patient access of Compassion Clinic services, specifically:
• All information given to patients should be handled in a quiet, private manner.
• All personal, confidential interviews will be conducted in private room areas.
• Privileged information about patients will not be discussed outside the clinic except with other healthcare
professionals for the purpose of patient care.
• The confidentiality of each guests’ protected health information.

I acknowledge that the above policy concerning confidentiality has been given to me, and I understand that policy as explained in this document. If I have any further questions, I will ask the Compassion Clinic Director, or on-site Clinic Leader.

LIABILITY WAIVER

I, (volunteer), hereby agree for myself and my heirs, estate, insurers and assigns to Compassion Connect and the Compassion Connect Clinics or any other volunteer entity, and their respective agents from responsibility for any loss, damages, injuries or death in connection with my volunteer services at the clinic. I agree to hold harmless Compassion Connect and the Compassion Connect Clinics or any other volunteer entity, from and for any sums, costs, or expenses (including attorney fees) incurred or paid in connections with any loss, damage, or injury or death arising out of my participation at the clinic, or the handling or treatment of pet(s). I acknowledge that Compassion Connect and the Compassion Connect Clinics or any other volunteer entity does not have medical insurance coverage for volunteers or caregivers.

PHOTO RELEASE

Photo​ ​Release For valuable consideration, receipt and sufficiency of which is hereby acknowledged, I hereby confer on Compassion Connect and the Compassion Connect Clinics or any other volunteer entity, and its designates the irrevocable and exclusive right to use my name, likeness, voice and/or reputation in all forms and media now known or hereafter developed and in any manners in connection with and related to any promotional/educational materials about Compassion Connect and the Compassion Connect Clinics or any other volunteer entity. I waive any right to inspect or approve any publication, use or photo. I release and agree to hold harmless Compassion Connect and the Compassion Connect Clinics or any other volunteer entity, its successors, assigns, designates and agents from any liability resulting from such use of my name, likeness, voice and/or reputation. I waive any claims I may have based on such use, including but not limited to claims for invasion of privacy, violation of right of publicity and libel.

I am over the age of 18, competent, and have the right to contract in my own name. I further affirm that my execution of this agreement does not and will not breach any other contract into which I have entered. I have read this release and fully understand its contents. This Release will be binding upon heirs, my legal representatives, assigns and me. (If you are under 18 your parent or guardian must agree to this document).