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 for Disease Control (CDC) and local health department guidelines, along with the Hope Center’s policies and procedures to reduce the spread of COVID-19. I understand that all volunteers must have received both doses of a Covid-19 vaccine, including a booster shot if eligible. I agree to follow the Hope Center’s masking policies, 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 *

Get Help

Emergency Shelter

360 W. Loudon Ave. Lexington, KY 40508


Hyde Hope Health Clinic: 859-225-5035

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

Reach Us

Men's Recovery Intake Number


Women's Recovery Intake Number


Donations & volunteers


The Hope Center is a 501c3 non-profit organization.
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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Last Updated: 5/23/2022