HH Reiki Application

Dear Volunteer Applicant,

Thank you for your interest in volunteering at Hartford Hospital. Please complete all required fields below to establish your applicant profile and apply for a volunteer position. Applications are reviewed by our managers as volunteer roles become available.

We are extremely grateful for the overwhelming interest in volunteer opportunities with our hospital. Because the number of applications we receive often exceeds our volunteer openings, we regret that we are not able to place every applicant.

***Please create your user name and a secure password.

***Secure passwords should contain a minimum of 5 characters with at least one number, one uppercase letter and one lowercase letter.

Volunteers are responsible for the safe-keeping of their passwords.

PLEASE DO NOT SHARE your password with anyone .

New User Details

User ID

User ID (verify)

Password

Password (verify)

* I attest that I am over 18 and out of High School

Personal

* Family/last name

* First name

* Street Address

* City

* State

* Zip/postal

* Home phone

Mobile

Do you speak any additional languages?

Contact Information

Highest education

Present School

Course of study

* Name of your emergency contact

* Best contact number

Second contact number

Are you now or have you ever been employed by Hartford Healthcare?

If yes, please select your facility below

Please check if currently employed

Current / Most Recent Employer

Position Held

Supervisor Name

Business Phone

How did you hear about our program?

* What date are you available to begin volunteering? (A minimum 6-month commitment is required)

* Thank you for your interest in volunteering in our Reiki program. What drew your attention to providing Reiki to hospital patients?

Are you Reiki trained?

If yes, what is your level of Reiki training?

* Where did you recieve your training?

What types of modifications of the Reiki practice do you think may be necessary in a hospital setting?

* I understand that documentation of an MMR vaccine, history of chicken pox or varicella vaccine, a recent Tuberculosis (PPD) test,  will be required to volunteer at Hartford Hospital

* I understand that flu vaccination is mandatory during flu season.

I hereby authorize Hartford HealthCare, its employees and agents to make recordings of me, whether audio or images, still or moving, and to alter and composite the same without restriction and without my inspection or approval, for use by Hartford HealthCare for any purpose in any and all media now or hereafter known, and to use my name in connection with said use if it chooses. I understand that this consent cannot be revoked, that it is effective in perpetuity, and that I have no expectation of payment in consideration for my authorization. I hereby release and hold harmless Hartford HealthCare, its employees and agents from all claims and liability relating to said recordings. I agree that a copy of this authorization will be as valid as the original.