Sanford Health Foundation

2024 MWC CMN Radiothon

Sanford Children's Hospital, 1600 W 22nd

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Your information


Required fields are marked with an asterisk (*).
First Name *
Last Name *
Company
Address *
City *
State *
ZIP *
Mobile phone *
Work phone *
Birthday *

A valid date as MM/DD/YYYY (for example: 11/30/2015)
Birthdate is required as some tasks require volunteer to be over 18 years of age.
Is anyone volunteering with you?
Select the additional volunteers attending with you:
Tip: don't count yourself - this is the number of people you are bringing to your shift(s).

Disclaimer

Privacy Information for Volunteers

Welcome to Sanford Health. We are proud of our facility and hope you enjoy your visit at Sanford.
The comfort and privacy of our patients is very important to us.

While we appreciate you taking time out of your busy scheduled to volunteer for the Sanford Health Foundation, we ask you please observe the following during your visit:

• Do not seek to learn patient names and the reasons they are in the hospital unless you have their permission.
• Our staff cannot share any information about our patients.
- You must know the patient’s name or have the patient’s permission before we can share their information.
- In some cases we need a written okay from the patient before information can be shared.
• Use of audio, camera or video recorder must be okayed with the Marketing Department. Ask before using any of this equipment while at Sanford.
• While at Sanford, please act the way you would want a visitor to act if you were the one not feeling well.
• Patient interviews must be set up with the Marketing Department
• Watching medical procedures must be set up in advance. The patient must give written consent.
• Do not go into any prohibited areas while visiting a patient. These areas include:
- Treatment rooms
- Procedure rooms
- Surgical suites
- Medical records storage areas
- Data processing and telecommunications equipment rooms
- Administrative offices.
• Ask your guide before going into an “off limits” area.

Authorization to follow patient privacy rules:
I recognize that Sanford Health is allowing me into areas where health information is protected by state and federal laws and regulations. Sanford Health rules and policies also protect this information.

I also agree that I will:
• Try not to learn the name of any patient, or try to get information about their medical care or condition;
• Not talk about or take with me any patient’s health information in any form during my visit. The patient must know and allow for any release of their health information;
• Not interview patients, work with patients, take pictures of patients, or use audio or video recorders without permission;
• Follow all rules said or written by any patient (or their legal representative) on using or sharing of the patient’s personal health information;
• Act in a fitting manner, listen to and follow the directions and orders of the doctors or staff.