Volunteer Health Questionnaire / Policy Form

As a volunteer for the Hope Center in Lexington, KY, I hereby acknowledge that said organization is doing everything they can to protect the public as well myself as a volunteer from COVID-19. To this extent, I agree to follow Center of Disease Control (CDC) and local health department guidelines, along with the Hope Center’s policies and procedures for social distancing to reduce the spread of COVID-19. I understand that all volunteers must have either received both doses of a Covid vaccine, and are 2 weeks post-vaccination, or have had Covid within the past 90 days and are safely out of quarantine. Volunteers will also be required to maintain six (6) feet of distance between myself, fellow volunteers, and Hope Center clients as much as possible. In addition, I agree to wear a mask to reduce the risk of exposure to myself and others while inside any Hope Center facilities. I agree to wash or sanitize my hands after using the restroom, sneezing, coughing, and before eating or preparing/serving meals, and will properly wear and utilize sterile gloves while serving food.  I will leave the Hope Center facilities if I begin to feel ill or experience COVID-19 symptoms, including cough, fever, or shortness of breath. I understand that I am volunteering in a higher-risk, residential setting, in which the COVID-19 virus can spread quickly. I agree to take all necessary precautions and adhere to Hope Center policies, and I understand that Hope Center staff members may ask volunteers to leave at any time, if they feel that the safety of clients and staff is at risk.

Volunteer Health Questionnaire / Policy Form
Do you agree to the Hope Center’s health and safety COVID-19 policy? *
Have you had any signs or symptoms of Covid in the past 24 hours such as cough, shortness of breath, loss of smell or taste, chills, felt "feverish" or had a temperature that is elevated for you/100.0F or greater? *
Do you have any of the following symptoms: Cough, Shortness of Breath or Chest Tightness, Sore Throat, Nasal Congestion/Runny Nose, Body Aches, Loss of Taste/Smell, Diarrhea, Nausea, Vomiting, Fever/Chills/Sweats? *
Have you traveled internationally or outside of the state in the last 14 days? Have you had any close contact in the last 14 days with someone with a diagnosis of COVID-19, or you yourself been diagnosed with COVID-19 and not yet cleared as noncontagious by state or local public health authorities? *
Which area would you like to volunteer for? *
Please select today's date
Confirmation *

Thank you for serving at the Hope Center. If you have any questions or concerns regarding our COVID-19 volunteer policy, please call our Volunteer Manager at 859-721-0144.

Get Help

Emergency Shelter

360 W. Loudon Ave. Lexington, KY 40508

859-252-7881

Hyde Hope Health Clinic: 859-225-5035

(For Recovery Program intake, call the Emergency Shelter and ask for Intake)

Reach Us

Men's Recovery Intake Number

859-252-7881

Women's Recovery Intake Number

859-252-2002

Donations & volunteers

859-721-0144

The Hope Center is a 501c3 non-profit.
For all donations or volunteer assistance contact the Development Department at 859-721-0144.

For Men’s Emergency Shelter and Recovery Program questions and intake call 859-252-7881.
For Women’s Recovery Program intake call 859-252-2002.

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