Cooley Dickinson Hospital Volunteer Application Form

Volunteer Application Form

Cooley Dickinson Hospital’s Volunteer Application Form

Thank you for your interest in Volunteering at Cooley Dickinson Hospital. We look forward to having you join us in providing outstanding care to our patients and their families.

To help us best utilize your time and skills, please complete the application form and return it to Volunteer Services. You must be at least 15 years old to apply. Once your application has been received we will contact you to arrange an interview.

The process for becoming a volunteer may take a few weeks. To protect you as well as patients, the following will need to be completed:

  • Criminal Records check (CORI) form (completed at interview)
  • TB screening
  • A copy of your immunizations [mumps, rubella (German measles), rubeola (measles), chickenpox and hepatitis B, if applicable]
  • COVID vaccines (2) and a booster
  • Two letters of reference
  • Orientation (held monthly and scheduled after TB screening has been completed)

We request a minimum commitment of 60 hours over 6 months. Exceptions may be made for students or with the permission of the department.

Robin Kline
Director of Volunteer Services



Cooley Dickinson Hospital
30 Locust Street
P.O. Box 5001
Northampton, MA 01061
Volunteer Services


If you are a student requesting an internship for credit, before applying you must have your internship approved by your school, then contact Volunteer Services at 413-582-2252. Internships require a contract with the school which may take a month to finalize, so we recommend you apply a semester in advance.

If you have any questions, please call the Volunteer Services Department at 413-582-2251 or 413-582-2252.