Annual Volunteer Compliance

Thank you for taking time to complete the annual volunteer compliance questionnaire. We appreciate your commitment and keeping up to date with important information. Please reach out to a member of Volunteer Services at (608)756-6739 with any questions or assistance required with completing this form.

Enter Your First Name *
Enter Your Last Name *
Enter Your Email Address *
1. The Mercyhealth mission statement is the following: *

1. The Mercyhealth mission statement is the following: A. Exceptional healthcare services with a passion for making lives better B. Always seek excellence C. With all my heart, with my entire mind D. To provide exceptional health care services, resulting in healing in the broadest sense
2. Everyone working in the hospital carries the responsibility of the safety and well-being of our patients and visitors. It is important everyone is aware of the signs and symptoms of stroke. The letter ‘B’ in BE FAST stands for: *

2. Everyone working in the hospital carries the responsibility of the safety and well-being of our patients and visitors. It is important everyone is aware of the signs and symptoms of stroke. The letter ‘B’ in BE FAST stands for: A. Bedside B. Balance C. Bright Lights D. None of the Above
3. What is the correct method for reporting a possible Mercyhealth policy violation? *

3. What is the correct method for reporting a possible Mercyhealth policy violation? A. Contact the Volunteer Manager (608) 756-6713. B. Report information to a leader on your unit or location C. Contact the Compliance Office at 608) 756-6156. D. All of the above are options to report a violation
4. When using hand sanitizer, I should *

4. When using hand sanitizer, I should A. Apply dime-sized alcohol gel to palm of one hand B. Rub hands together until dry C. Cover all surfaces of the hands and fingers including beneath fingernails D. All of the above
5. The only way to protect patient privacy and confidentiality is: *

5. The only way to protect patient privacy and confidentiality is: A. Only access the information needed for your job. B. NEVER talk about patients in any way that would make them identifiable to others. C. Don’t ask confidential questions unless you really need to know the answers to do your job. D. Do not look up your own information or a relative’s information on EPIC. E. All of the Above
Volunteers are allowed in patient isolation rooms *
Volunteers should report safety hazards only if someone gets hurt *

False – You should always report concerns to or hazards to prevent others from injury
When talking with others, we respect all diverse customers that we come in contact with; we do not judge a person by how they look, speak, act, or their beliefs *
Mercyhealth has a system-wide, plain language emergency alert system to ensure the safety of our partners, patients and visitors at any of our facilities. *
If I am experiencing any cold-like symptoms I should come to the hospital and let Volunteer Services know *

False – Please contact volunteer service at (608)756-6739 to discuss your symptoms and if it would be appropriate for you to attend your shift
Mercyhealth has a no photos or video policy for all people in all areas of the hospital *
Critical Moments of Service is a partner and volunteer’s behavior standard to ensure respect, professionalism, safe and caring environment, privacy and confidentiality, and good communication *
All Mercyhealth partners, whether an employee or volunteer, have a responsibility to respect and maintain patient confidentiality at all times *
Mercyhealth requires of our regular volunteers during the initial onboarding process as well as annually, including: completing an application, personal interview, general orientation, health requirements, signing paperwork, completing a background check and training in the assigned role *
To remain in active volunteer status, volunteers are asked to complete a minimum of 25 hours annually *