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(620) 357-8361
809 W. Bramley St, P.O. Box 310 Jetmore, KS 67854
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ABOUT US
Mission, Vision & Values
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SERVICES
O’Shea Memorial Clinic
Acute Care (Staffed 24/7)
Emergency Room (Staffed 24/7)
Radiology
Laboratory
General Surgery
Physical Therapy
Intermediate Swing Bed (Staffed 24/7)
Wound Care
Chiropractor (Tues/Thurs Mornings)
Transportation Bus
Pulmonary Rehabilitation Program
Skilled Swing Bed (SSB)
Pain Management
OUR COMMUNITY
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Advance Directives
DNR: “Do Not Resuscitate Directive”
Durable Power of Attorney
Living Will
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No Surprise Billing Disclosure Form
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Patients Registration Form
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CareLearning
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EMR Login
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Volunteers
CAREERS
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CONTACT US
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ABOUT US
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Mission, Vision & Values
Providers
SERVICES
Menu Toggle
O’Shea Memorial Clinic
Acute Care (Staffed 24/7)
Emergency Room (Staffed 24/7)
Radiology
Laboratory
General Surgery
Physical Therapy
Intermediate Swing Bed (Staffed 24/7)
Wound Care
Chiropractor (Tues/Thurs Mornings)
Transportation Bus
Pulmonary Rehabilitation Program
Skilled Swing Bed (SSB)
Pain Management
OUR COMMUNITY
PATIENTS & VISITORS
Menu Toggle
PARA Price Transparency Tool
Advance Directives
Menu Toggle
DNR: “Do Not Resuscitate Directive”
Durable Power of Attorney
Living Will
Patient Portal / Online Payment
No Surprise Billing Disclosure Form
Guide
Privacy Policy
Records Request
Patients Registration Form
Chargemaster
EMPLOYEE CORNER
Menu Toggle
CareLearning
Employee Email
ADP
EMR Login
Join Us
Volunteers
CAREERS
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CONTACT US
Volunteers
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Home Phone:
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Mailing Address (if different):
Present Employment (if applicable)
Work Phone:
In case of emergency, notify:
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Telephone:
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Name of Physician:
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How did you learn of the volunteer program at Hodgeman County Health Center?
Have you been involved as a volunteer in any capacity?
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when and where:
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Please list possible time for volunteering (state hours):
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Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
List several things you like to do most with your time:
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List several things you like to do least with your time:
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List special skills you may have and wish to share:
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What do you hope to receive from your volunteer experience?
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List any serious illness you have had in the past five years:
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Please list activities and positions (paid or volunteer) which have been most significant to you:
Activity/Position
What I like Best About It
What I Liked Least
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ACUTE CARE
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EMERGENCY ROOM
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LABORATORY
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SURGERY
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RADIOLOGY
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CHIROPRACTOR
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TRANSPORTATION BUS
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WOUND CARE
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PHYSICAL THERAPY
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HOLISTIC PAIN
+ LEARN MORE
INTERMEDIATE SWING BED
+ LEARN MORE
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