Volunteer Services Survey

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* 1. Contact Information

Hospital Name

Director of Volunteer Services

Email Address

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* 2. Please Choose the Type of Facility that Represents your Hospital:

Acute Care

Critical Access

Psychiatric/Chemical Dependency

Rehabilitation

Long-Term Acute Care

Not Sure

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* 3. How many volunteers do you have at your hospital? (Include active and PRN – excluding teen volunteers)

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* 4. How many teen volunteers do you have at your hospital?

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* 5. In how many departments of the hospital do your volunteers provide assistance (e.g., lab, x-ray, library, transport, gift shop, cafeteria, etc.)?

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* 6. Amount of funds raised 2018-2019:

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* 7. Amount donated to the hospital in 2018-2019:

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* 8. Amount donated to community in 2018-2019:

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* 9. How many scholarships did your volunteer/auxiliary group award in 2018-2019?

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* 10. What is the total amount of scholarship funding you provided?