Norwalk Hospital

If copies of your records are going directly to a physician or hospital, there is no charge.  If copies are being sent directly to you, there is a fee of 12 cents per page. An additional form is required to obtain records for a deceased patient. Please find additional forms below:

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  Affidavit of Distributee

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  Health Care Proxy/Surrogate Certification

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If you identify that information in your medical record is incorrect, please submit a completed form to amend health information. Include your current address and phone number.

Patient Request to Amend Health Information (PDF)

Fax or mail form to:
The Summit
100 Reserve Road
Danbury, CT 06810
Attn: Health Information Management    
Fax: (203) 749-9000

We welcome caring individuals to join our team. Matching the right volunteer to the right position is essential to the success of our program.

To ensure a successful volunteer experience, we make an effort to find or create volunteer opportunities that match your interests. Volunteer opportunities include, but are not limited to:

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  Emergency Department: Work closely with the Emergency Department leadership and staff to provide support services to staff, patients and their families.

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  Music Therapy: Volunteers trained in the clinical use of music to accomplish individualized goals such as reducing stress, improving mood and self-expression.

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  Volunteer Transport: Assist staff and families in various departments to help transport patients throughout clinical areas of the hospital. Transport volunteers may also wheel discharged patients from their rooms to patient pickup areas.

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  Gift Shop: Greet and assist customers and staff within our gift shop.  Our gift shop volunteers also work with staff to help keep the store maintained and organized.  Volunteers also perform point of sale transactions, while providing excellent customer service.

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  Patient Care Areas: Assist a variety of departments with delivering kind, compassionate care to our patients, guests and staff.

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  Clerical Support: Assist office staff across several departments within the hospital.. These volunteers help staff with clerical duties including filing, copying and faxing, answering phones, data entry, and greeting visitors.

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  Art and Hospitality Cart: Our hospitality and art cart volunteers are vital in bringing genuine joy to our patients. Volunteers assist by bringing art supplies and projects to patients within different departments.

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  Goldstone Caregiver Coach: Caregiver Coaches work to provide support to the caregivers of patients throughout the hospital and encourage them to engage in self-care, with the goal of reducing caregiver stress. Our Caregiver Coaches are compassionate, empathetic and self-reflective individuals who are comfortable with providing support to caregivers in need. While personal and/or professional caregiving experience has been helpful in enhancing the empathy of those who become Caregiver Coaches, it is not a requirement.

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  Patient to Patient, Family to Family Emotional Support Volunteer: Peer-to-peer supporters are people who have “been there.” They are empathetic and compassionate, working with those who have similar life circumstances to their own. Although the experience of one person can never be exactly the same experience as another, having someone to relate to can be incredibly supportive and reassuring. A peer-to-peer supporter, using the appropriate skills, can help an individual navigate their health journey from a physical, emotional and spiritual perspective.

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  Pet Therapy: This program welcomes volunteers whose dogs are qualified with an approved organization (Good Dog Foundation, Therapy Dogs International and Pet Partners) to engage with patients and staff throughout the hospital. Volunteers must be 18 years or older to participate and able to commit to at least three visits per month.

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We carefully screen all volunteers before processing and placing them in appropriate assignments. Our process includes:

• Medical clearance:

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    A two-step PPD Skin Test (completed at your PCP or for free at Employee Health Services within Norwalk Hospital); or may provide proof of negative Quantiferon blood test within 30 days of starting.

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    Proof of MMR (Measles, Mumps, and Rubella) immunity, in the form of two vaccines or a positive blood titer test. 

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    Proof of Varicella (chicken pox) immunity in the form of two vaccines or a positive blood titer test.  We also accept two doses of the Shingles vaccine in lieu of Varicella vaccination.

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    Annual Influenza Vaccine Proof

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    Health Assessment signed by physician, proving that the volunteer is free and clear of communicable disease.

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  Compliance clearance, fulfilled through completion of forms and attestations

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  Interview with the Manager of Volunteer Resources and Volunteer Coordinator

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  Reference checks

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  Criminal background check

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  Attendance at a mandatory training/orientation

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To learn more please contact Jennifer Cebrian, Manager of Volunteer Services at Norwalk Hospital: [email protected] or (203) 852-2054.

Applications

Adult Volunteer

Student Volunteer (under 18)