Pet Therapy Application

After you complete your application, submit the required Health Documentation for you and your pet at https://umiami.vsyslive.com/.

If you are a current UHealth Employee, health documentation does not need to be uploaded.

Applications will not be reviewed until all required documents are uploaded in the PDF format and may take up to 7 business days to review.

New User Details

User ID

User ID (verify)

Password

Password (verify)

Personal Information

* Last Name

* First Name

Middle Name

* Date of Birth

Citizenship Status Required:

U.S. Citizen

Permanent Resident

Neither

Current Address:

* Street

* City

State

* Zip Code

Telephone Number(s) with area code:

Day

Evening

* Cell

* E-mail address:

Emergency Contacts

* Name:

* Relationship to you:

Telephone Number:

* Cellular Number:

Physician's Name:

Hospital Affiliation:

Physician's Telephone Number:

Volunteer Service Information

Volunteer Types

* What language(s) do you speak?

Have you ever volunteered at UHealth?

If yes, please indicate:

* Start Date

* End Date

* Volunteer Position

* UHealth Department

* Location

* Contact / Supervisor

Name(s) and Department(s) of family members employed at UHealth (if applicable):

Availability

Monday Morning

Tuesday Afternoon

Wednesday Morning

Thursday Morning

Friday Morning

References

* Name

Relationship

* Telephone

* E-mail Address

* Name

Relationship

* Telephone

* E-mail Address

Please complete at least one written reference letter.

Please click here to download the Reference Check form.

* Upload-Reference check

Upload-Reference check (Optional)

Education, Training, and Interest

Relevant Education - If student, indicate: Academic Affiliation

Graduation Year

* Relevant training, skills, and experience:

* Why do you choose to volunteer at UHealth?

Signature

I certify that all statements in this application are true. I also agree that if I am accepted as a volunteer, I will abide by all regulations of UHealth.

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Applicant's Signature