Thank you for your interest in supporting the David Bradley Children's Bereavement Program- Grief Reach: Rediscovering Family, Rediscovering Fun. 

Please complete the following application. 

If you have any questions or concerns, please contact  hchsvolunteerservices@uphs.upenn.edu

Demographic Information

Emergency Contact

Volunteering Background

Grief Reach Specific Questions

Reason for Volunteering

Loss History

Roles

Wissahickon Hospice also asks that volunteers comply with the following requirements:

  • Provide results of yearly TB tests
  • Documentation of MMR Vaccination or immunity
  • Documentation of Varicella Vaccination or immunity
  • Provide Wissahickon Hospice (should you drive) with a copy of your current driver's license and current valid auto insurance card.
  • Allow us to complete an Act 34 (PA State Background Check)
  • PA Child Abuse Clearance
  • FBI Fingerprint Clearance
  • Provide 2 letters of recommendation

I certify that the statements made on this application for a Hospice Volunteer position are true and correct, and I hereby grant Wissahickon Hospice permission to verify the information contained herein. I understand the giving of false information or the failure to give complete information requested herein shall constitute grounds for rejection of my application or my dismissal from the program. I understand that my appointment with the Hospice is contingent upon the satisfactory completion of the required orientation and training, and the receipt of satisfactory recommendations from references. I also understand that the Hospice reserves the right to require tests for drugs and/or alcohol in my system for just cause or reasonable suspicion. I hereby grant permission for the authorities of Wissahickon Hospice to investigate my references and release the Hospice and all previous employers or references from any and all liability resulting from such investigation. Upon becoming inactive as a Hospice Volunteer, I authorize the release of reference information on my work.