Volunteer

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Individual Volunteer Opportunities

Preferred Date(s)

Group Volunteer Opportunities

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To complete the volunteer application, all applicants must read and sign the following Confidentiality Statement.

I have read and understand the Confidentiality Statement. *

I, the undersigned volunteer of The Healing Place of New Hanover County, understand that by virtue of my volunteering, I have been given access to proprietary and confidential business and client information: I further recognize that persons with mental illness, emotional disorders, development disabilities and/or chemical dependency are vulnerable and that mental health care professionals have a duty to report statutory and ethical violations to certain state agencies and professional licensure boards; I. Definition of Confidential Information: Confidential Information shall include but not be limited to the following: A. Information contained in case records, histories, personnel and regular files which pertains to clients, staff members (including specific practice privileges granted or denied), or committees (including date compiled by the Personnel/Staff Development Committee and the Research and Evaluation Committee involving the professional conduct or competence of a staff member); and B. All documents related to matters described above, and all business records (including interoffice correspondence, procedures, strategies, compilations, programs, data, techniques, manuals, client/patient lists, research projects, or internal review of critical incidents). II. Use of Confidential Information: With respect to the Confidential Information, the undersigned shall: A. Maintain Confidential Information in full confidence and not reveal to any other clients, firms, professional or other organizational groups with whom I am associated or neither to which I belong nor to make any disparaging remarks which relate to the Confidential Information; B. Utilize the information disclosed to me for the purpose of carrying out the responsibilities of my position and take special care not to incorporate any of the information disclosed to me by one client regarding care rendered to another client; C. Restrict disclosure solely to those employees, committee or board members with a need to know and advise them of their concomitant duty not to disclose Confidential Information to third parties. Notwithstanding anything to the contrary, the undersigned's obligation to maintain the confidentiality of Confidential Information shall not supersede an obligation to report (or to be satisfied that The Healing Place of New Hanover County has properly reported) required information to a state agency and/or professional licensure committee or to otherwise comply with federal, state or local laws.

Your Typed Name Serves as Your Electronic Signature *

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