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Volunteer Services - Request a Leave of Absence

Any active, on-site hospital volunteer with a record in good standing who wishes to take a leave from volunteering lasting six weeks to a maximum of nine months from their last recorded hours should submit this Leave of Absence form. They must also notify their Staff Volunteer Supervisor, College Student Leader Board member, and/or Community Volunteer Lead. Volunteers on Leave of Absence keep their photo ID badges and continue to receive general communications from our department but will not have compliance requirements.

For example, the Leave of Absence form should be completed if you plan to take the summer off or have a temporary health concern. You should return your photo ID badge to the Volunteer Services office if you plan to take two semesters off or expect to be away from service longer than nine months.

If you have questions about the best plan for your particular situation, please contact the Volunteer Services office and a staff member will assist you.

The beginning date of your leave.
The date you can return to work.

I understand that by becoming a volunteer at UI Hospitals and Clinics, I committed to volunteering three hours per week for six consecutive months or two semesters. Considerable hospital resources have been dedicated to screen, collect background information, health screen, photo ID badge, appropriately orient, assess, train, place and supervise me, and my dependability directly affects the quality of my placement, especially if I have direct patient contact. By submitting this request, I acknowledge I am aware of my obligations and will fulfill my commitment upon the completion of my leave.

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