New User Details
ADULT Emergency Center
* Indicates Required Fields to Submit Application
Your Information
Teen - Must have completed the ninth grade.
Adult - 18+ year of age and completed highschool
Emergency Contact Information
Work Information
School Information
Community Involvement

Statement of Understanding And Agreement

Johns Hopkins All Children's Hospital (JHACH)l is a drug free campus.  I understand that by applying for a volunteer position, if accepted, I may be subject to a drug screening.

JHACH requires volunteers to commit to volunteering a minimum of a six month period (generally one day a week for two to four hours).  This requirement must be fulfilled in order to receive any correspondence (i.e. Hours, Letters of recommendation, etc...) from the Volunteer Resources Office.

I certify that the information given by me in this appilcation is true in all respects and that I have not made any willful omissions.  I agree to abide by all present and subsequent rules and regulations of JHACH and understand such rules and regulations may be modified at any time, such deemed necessary by JHACH.

I understand that if accepted into the volunteer program at JHACH that I am required to have immunity to Chickenpox, Measles, Mumps, and Rubella.  To verify immunity, I must provide the following information to JHACH Occupational Health:
     Varivax (Chicken Pox)
           Written documentation with 2 doses of vaccine,
           Laboratory evidence of immunity,
           Diagnosis of history of varicella disease by a health-care provider, or diagnosis of history of herpes zoster by a health-care provider.

     MMR (Measles, Mumps, Rubella
          Born in 1957 or later:
               Proof of immunity includes one of the following:
                    - Two vaccines after 12 months of age.
                    - Laboratory evidence of immunity for Measles (Rubeola), Mumps, and Rubella.

   TuberculosisA TB screening will be provided by the hospital if your application is accepted.

Immunization/immunity records may be acquired from either your doctor, school, university, or the Public Health Department.

Furthermore, I understand that if selected to volunteer, disclosure of confidential information concerning the hopital or a patient may cause immediate dismissal.  By submitting this application, I am agreeing to these requirements as set by theJHACH Volunteer Resources Office.