Support Us

Volunteer

Thank you for your interest in volunteering at HealthPoint. We value compassion, quality and innovation and look forward to talking with you about your interests.

The minimum time requirement for volunteering at HealthPoint is 32 hours which can be spread over two months if necessary. Please complete the information below and submit via the button at the bottom of the page. Available positions change regularly and vary by location. Some positions are more difficult to get into than others. Click here for a list of volunteer job descriptions.

Additionally a CV or resume plus a letter of reference can be mailed to Volunteer Program, 955 Powell Ave. SW, Renton, WA 98057, e-mailed to volunteer@healthpointchc.org or faxed to the attention of Volunteer Program at 425-277-1566.

Your Information

Full Name*

First, MI, Last

Birthdate*

mm/dd/yyyy

Gender*

Male Female

Address*

City, State, ZIP*

Phone*

(nnn) nnn-nnnn

Cell Phone/Pager

(nnn) nnn-nnnn

E-mail*

Resumé or CV

doc, rtf, txt, pdf

Emergency Contact

Full Name*

Relationship

Address*

City, State, ZIP*

Phone*

(nnn) nnn-nnnn

Alternate Phone

(nnn) nnn-nnnn

More About You

In addition to English, what languages do you speak?

Have you ever been convicted of a felony? Yes No

Occupation*

Student Employed
Unemployed Retired

Availability & Interests

Please indicate the hours you are available to be in clinic.*

Mondays

8a-12p 1-5p

Tuesdays

8a-12p 1-5p

Wednesdays

8a-12p 1-5p

Thursdays

8a-12p 1-5p

Fridays

8a-12p 1-5p

Available Start Date*

mm/dd/yyyy

Which HealthPoint Clinics are you interested in?*

Auburn	Bothell	Federal Way
Kent	Renton	Redmond
SeaTac	Tyee	Administration

Are you currently a patient, or ever been a patient at HealthPoint? Yes No

How did you hear about HealthPoint?

Why are you interested in HealthPoint?

What goals would you like to accomplish during your experience with us?

What prior experiences have you had that you think may be relevant?

What skills do you have that you think may be useful during your experience?

Please list your top three Volunteer Position Choices:

1st position choice*

2nd position choice

3rd position choice

Submission & Acknowledgements

I understand that any offer of volunteer placement is contingent from satisfactory results of a criminal background check. I authorize the investigation of all statements obtained in this application for volunteer placement. I understand that misrepresentation or omission of facts called for hereon will be sufficient cause for cancellation of consideration for volunteer placement or dismissal from the agency’s service if I have been placed.

I agree that HealthPoint shall not be held liable in any respect if any volunteer placement offer is not tendered, is withdrawn, or is terminated due to falsity of the statements and answers in this application form.

I am advised that in compliance with the Fair Credit Reporting Act, a routine investigation may be made concerning my character, general reputation, personal characteristics and mode of living. I have the right to make a written request, within a reasonable period of time, for a summary disclosure of the nature and scope of the investigation.

BY SUBMITTING THIS ONLINE FORM, I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE STATEMENT AND UNDERSTAND IT.

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