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Home Volunteer Services High School Volunteers Junior Volunteer Application

Junior Volunteer Application

Thank you for your interest in volunteering at UCI Health. 

We are currently reviewing interest forms. Please be patient as we work through the large number of interest forms we received. We will notify you by email with an updated status. 

Contact Information

Local Emergency Contact

Education Information

Volunteering Interests

Commitment Statement

I understand and agree that in the performance of my duties as a volunteer with UCI Health I must abide by all policies and procedures, including to hold as strictly confidential all medical information that I may obtain directly or indirectly concerning patients. I understand that failure to comply with these requirements may result in my dismissal as a volunteer. I am volunteering my services to the University of California solely for my personal purposes or benefit without promise or expectation of compensation or University benefits. I agree to serve as a volunteer without salary for a minimum of 100 hours. If the volunteer is a minor, then the signature of a parent or guardian is required.

Parental Consent

I give my consent for my child to participate in the Junior Volunteer Program at UCI Medical Center