Cooley Dickinson Health Care 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]
- 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.
Director of Volunteer Services
Please fill out the form below completely and then click the “submit” button to submit your volunteer application. It is the intent of CDHC to conform to Federal and State Laws pertaining to non-discrimination.
If you would prefer to download, print and mail your application, please click HERE for a downloadable PDF and mail to:
Cooley Dickinson Hospital
30 Locust Street
P.O. Box 5001
Northampton, MA 01061