Fort Wayne Area
5910 Homestead Road, Fort Wayne, IN 46814
Tel: (260) 435-3222

Volunteer Application

Visiting Nurse is an equal opportunity organization. Applicants to volunteer are considered for participation without regard to race, color, national origin, religion, sex, age, sexual orientation, disability, citizenship status, or any other basis prohibited by law. VNHH will comply with its obligation to provide reasonable accommodation to qualified individuals with disabilities. VNHH is committed to selecting volunteers based on their character, ethics, interest and ability to participate in our programs. It is imperative that the character and reputation of our volunteers be above reproach. For this reason, it is necessary that VNHH verify information about each applicant’s background. This is for the protection of our employees, volunteers, and program participants.

Contact Information





Please list 3 people who know you well (not family) who can attest to your character. Please include name, street address, city, zip code, phone number, and association.
Reference 1
Reference 2
Reference 3

As part of our volunteer hiring process, we will run a Criminal History by the state of Indiana.

Volunteer Confidentiality Policy

By submitting this application, I agree to the terms in the section below and acknowledge that this is a digital signature.

I shall hold in confidence all written and spoken patient information. I will not violate the confidential relationship between VNHH staff, volunteers, patients, and families and I will not remove any written records from the office without expressed permission.

I accept full responsibility for maintaining the confidential and private nature of all VNHH patient information. I understand that I am personally responsible and liable for any violation of this statement.