Volunteer Application Form - Grove Park Home

Your Information
Name*
First Last
Address*
Street Address Address Line 2 City Postal Code
Email*
Phone (Home)*
Phone (Business)
Occupation
School
Emergency Contact
Name*
Relationship*
Address*
Phone*
Other Information
Interests*
- Fundraising
- Feeding
- Gardening
- Palliative Care
- Special Events
- Computers/Wii
- Friendly Visitor
- Maintenance
- Entertainer
- Shopping Assistant
- Cafe
- Hairdressing Assistant
- Office
- Spiritual
- Restorative Care
- Life Enrichment Programs (ex: Crafts, Music, Games)
Check all areas of interest that apply
Hours and Days Available
Sunday
- Morning
- Afternoon
- Evening
Monday
- Morning
- Afternoon
- Evening
Tuesday
- Morning
- Afternoon
- Evening
Wednesday
- Morning
- Afternoon
- Evening
Thursday
- Morning
- Afternoon
- Evening
Friday
- Morning
- Afternoon
- Evening
Saturday
- Morning
- Afternoon
- Evening
Personal References
Name*
Address
Phone
Name*
Address
Phone
I give permission for my photo to be used for GPH use*
- Yes
- No
I understand all volunteers are required to have a Criminal Reference Check / Vulnerable Sector Screening before starting.*
- Yes
- No
Declaration - Will participate in receiving annual influenza vaccination*
- Yes
- No
Influenza vaccinations are available annually and will be supplied by Grove Park Home
Declaration - Have received a complete series of the COVID-19 vaccination (2 doses). Proof of vaccination will be required prior to start date*
- Yes
- No
While required for entry into long-term care
I hereby authorize the individuals that I have listed as references to provide any and all information to Grove Park Home, and I release Grove Park Home from any liability that may result from this discolosure*
- Required

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IMPORTANT REPORTS

Visitor Policy
2023 Quality Improvement Report
Emergency Preparedness Plan
Pandemic Plan
Accessibility Plan
GPH Strategic and Risk Management Plan 2024

Ministry of Long-Term Care Action Line is: 1-866-434-0144

ABOUT GROVE PARK HOME

Grove Park Home is a charitable, not-for-profit, Long Term Care Home established in Barrie in 1968. The Home provides care for 143 Long Term Care residents, as well as offers Retirement Living suites and an Adult Day Program.

All Grove Park Home Resident rooms are fully air-conditioned.

USEFUL LINKS

Privacy Policy
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Employee Portal
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QUICK LINKS

Home & Community Care NSM
MLTC
L-SAA Agreement
Quality Improvement Plans
Ontario LTC Home Portal
Public Health Inspection Connection

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Employee Portal / Careers

Located at

234 Cook Street
Barrie, ON L4M 4H5

Call us anytime

(705) 726-1003

Email us at

info@groveparkhome.on.ca

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Home
About
Long-Term Care
Retirement Living
Adult Day Program
Events
Support Us

Your Information

Emergency Contact

Other Information

Hours and Days Available

Personal References

Located at

Call us anytime

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