Annual Paperwork

Please choose the appropriate 2019 volunteer packet below.

  • LDHH - For those volunteers who have a regular shift at any LDHH inpatient unit. If you have a back-up shift but provide most of your volunteer support in homes or HART communities, please choose a packet below.
  • Homecare - For those volunteers who provide support in the home ONLY. If you are a back-up at LDHH-H or LDHH-S but regularly provide direct patient support in the homes, then you will complete these forms. If you provide both home and HART support, then please use the HART packet below.
  • HART - For those volunteers who provide support in HART communities. Effective immediately, HPCCR volunteers that go into long term care communities (otherwise known as HART communities) are required to have an annual Tuberculosis skin test, rather than complete the TB Screening Form. This is written into the contract we have with each community, and also applies to HPCCR staff. If we do not abide by this stipulation, we could risk losing contracts with area communities, thus preventing residents from having access to quality end of life care. This will be an annual requirement from now on. Please check your email or call your volunteer manager for details on getting yours.
  • Office/Special Event - or those volunteers who do NOT provide direct patient/family support.
  • SC Volunteers - For those who reside in South Carolina.

Please note that each packet contains a TB Screening form. If you have had a POSITIVE TB test with HPCCR and have a chest x-ray on file, then you will need to contact Anita to receive a different form in the mail to complete.

The forms can be printed and faxed to us at 704.335.4304, Attn: Anita Gluodenis, or scanned in and emailed to They may also be mailed to Attn: Volunteer Program Manager, HPCCR, P.O. Box 470408, Charlotte, NC 28247.

If you have questions about any of the annual requirements, please feel free to ask anyone in the Volunteer department.

Volunteer Request and Profile Form examples