Volunteer Agreement Form

Thank you for volunteering with Alaska Behavioral Health!

To maintain client privacy according to federal laws, all volunteers and visitors to Alaska Behavioral Health are required to

sign a confidentiality agreement. Please read and sign the following.

As a volunteer, I understand my roles and responsibilities are a valuable part of Alaska Behavioral Health, and

I agree to carry out my responsibilities to the best of my ability. As I carry out my responsibilities, I may meet

• Not to share or discuss Alaska Behavioral Health data on clients, donors, staff, volunteers,

corporations, foundations and affiliated organizations.

• Not to access confidential information for purposes other than official Alaska Behavioral Health

business.

• Not to take any photographs or record any information while on ACMHS/FCMHS/Alaska Behavioral

Health property without specific permission.

• To represent Alaska Behavioral Health in a safe, positive, and professional manner.

• To follow the guidance of Alaska Behavioral Health staff where I am volunteering.

• To ask for help when needed.

• To ask questions when needed.

I am aware that any activity, including volunteering with Alaska Behavioral Health and its programs, can

expose me to risk of injury or death. I hereby voluntarily and knowingly enter into this waiver and release of

liability and do hereby release and forever discharge Anchorage Community Mental Health Services, Inc. dba

Alaska Behavioral Health (corporate headquarters located at 4020 Folker St, Anchorage AK, 99508) and its

staff, board members, agents and volunteers for any physical or psychological injury that I may suffer as a

direct result of my volunteer activity at Alaska Behavioral Health.

Printed Name_________________________________________ Address __________________________

Signature _________________________________________________ Date: _______________________