UW OTD Volunteer Confidentiality and Agreement Form
UW Organ and Tissue Donation (UW OTD) in Madison, Wisconsin, has a large group of volunteers that assists in our efforts to educate the public about organ, tissue and eye donation.
UW OTD Volunteer Confidentiality Agreement
a) I shall hold as absolutely confidential all information that I may obtain directly or indirectly concerning patients or medical staff, and not seek to obtain confidential information from a patient. I understand that release of such information will result in discipline that can include termination from the UW OTD Volunteer Program.
b) My services are donated to UW OTD without contemplation of compensation or future employment and given for humanitarian and charitable reasons.
c) I shall be punctual and conscientious, conduct myself with dignity, be courteous and considerate of others and endeavor to make my work professional in quality.
d) I shall attempt to resolve any problems related with my volunteer activities with the UW OTD Volunteer Coordinator.
e) I shall make my best effort to fulfill my commitment to UW OTD by completing all assignments I accept. I will immediately notify UW OTD at 608-265-0356 should any problems arise that would keep me from my assignment.
f) I shall at all times be a champion for organ donation and promote the life-saving benefit of donation.
g) I shall at all times uphold the Mission and Vision of UW OTD.
- Mission: UW Organ and Tissue Donation advocates for organ donors, donor families and recipients and educates health care professionals and the public to enrich and save lives through organ and tissue donation.
- Vision: Universally recognized as a preeminent organ procurement organization, we will identify and maximize every opportunity to save lives through organ donation.
h) I understand that UW OTD reserves the right to terminate any volunteer status as a result of:
- Failure to comply with UWHC policies, rules and regulations
- Absences without notification
- Unsatisfactory attitude, work or appearance
- Other circumstances which, in the judgment of the area supervisor or Volunteer Manager, would make my continued services as a volunteer contrary to the best interests of UW OTD.
i) I understand that due to the large volume of requests for volunteer opportunities, all communication regarding volunteer opportunities is shared via e-mail.
j) I understand that UW OTD assumes no responsibility for any contact, visits or services provided by me outside of the responsibilities assigned through the volunteer program of UW OTD.