Florida Hospital Volunteer Services Orientation Declaration This is to certify that I, ___________________________ have attended the Volunteer Services Orientation and received direction in the following areas of concerning Florida Hospital policies and procedures: Welcome Risk Management / DNV / AHCA Florida Hospital’s History Looking Right Mission Statement, Vision, Values On the Job Scope & Purpose of Handbook Discipline Policy Compassion Behaviors Wheel Chair Safety & Lifting Infection Prevention Annual Updates: BARE Facts Patient Experience Severe Weather Infection Prevention / Needle Stick Hotline At Your Service Corporate Compliance & HIPAA Solicitation Safety & Environment of Care Good Things to Know STAT Code Red –RACE, PASS In addition to completing the proper forms, I will abide by the HIPAA (Health Insurance Portability & Accountability Act) Federal Law and the Florida Hospital rules and policies regarding confidential information. At all Florida Hospitals report accident to your respective campus Volunteer Services Department and your supervising department immediately. The Volunteer Services Department Manager or the staff contact/coordinator in your area of service will need to fill out a Riskmaster for you. The Risk Management Department of Florida Hospital will review the report and determine what actions, if any, need to be taken. Volunteers are not Florida Hospital Employees, therefore are not covered under FH insurance, and will be responsible for their own medical expenses. __________________________ ____________ ______________ Signature of Above Named Individual FH Campus Location Date of Orientation