Volunteer Application

ElderNet provides a safety net for older and disabled adults to help them remain in their homes with dignity and strengthens food and financial security for all community members in need of support.

Volunteer Form
ElderNet provides a safety net for older and disabled adults to help them remain in their homes with dignity and strengthens food and financial security for all community members in need of support.
Which do you prefer to be contacted on?
How long have you lived in Pennsylvania?
Race (For Reporting Purposes Only)?
How would you like to help?
Driving to medical appts:
Essential errands to bank, pharmacy, etc
Pantry
Special Events
Grocery shopping
Friendly Caller
Friendly Visitor
Odd Jobs
Other Information Needed:

As part of ElderNet’s application process, we will need a few more pieces of information from you:

  1. A copy of your driver’s license or other government-issued ID. This will be used to complete a
    background check for all volunteers.
  2. Have you used any other first or last names? This will help complete the background check.
  3. A copy of your car insurance card. For volunteers who will be escorting participants only. We
    will also need updated insurance information when your policy is renewed or changed.
  4. Three references.

Reference 1

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Reference 2

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Reference 3

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Ombudsman Programs

Neighborhood Interfaith Movement

7047 Germantown Ave.
Philadelphia, PA 19119
(215) 843-0304

http://www.pcacares.org/ServiceDetail.aspx?service=Neighborhood+Interfaith+Movement+(NIM)+-+Nursing+Home

Services Provided: Information and referrals; Volunteer Ombudsman training; Telephone resource line for adults 55+ in Northwest Philadelphia.

Ombudsman, Montgomery County

1430 DeKalb St, 2nd Floor
Norristown, PA 19404
(610) 278-3601

http://www.montcopa.org/mcaas

Services Provided: An ombudsman handles complaints about nursing homes and investigates whether or not patients are receiving adequate care.

Ombudsman, Chester County

601 Westtown Rd, Ste. 320
West Chester, PA 19380
(610) 344-6350 / (800) 692-1100 ext. 6350

http://www.chesco.org/index.aspx?nid=135

Services Provided: An ombudsman handles complaints about nursing homes and investigates whether or not patients are receiving adequate care.

Ombudsman, Philadelphia County (CARIE)

100 S. Broad St, Ste. 1500
Philadelphia, PA 19110
(215) 545-5724 / (800) 356-3606

http://www.carie.org/

Services Provided: An ombudsman handles complaints about nursing homes and investigates whether or not patients are receiving adequate care.

Ombudsman, Delaware County

206 Eddystone Ave, 2nd Floor
Eddystone, PA 19022
(610) 490-1300 / (800) 416-4504

http://www.delcosa.org/

Services Provided: An ombudsman handles complaints about nursing homes and investigates whether or not patients are receiving adequate care.

CARIE – Center for Advocacy for the Rights and Interests of the Elderly (CARIE)

1500 JFK Blvd., Suite 1500
Philadelphia, PA 19102
(215) 545-5728 / (800) 356-3606

http://www.carie.org/

Services Provided: Information, education, and advocacy intervention through CARIE LINE telephone service; Special assistance to elder abuse/crime victims; health and in-home care consumers in the community; and managed care/HMO consumers; Report health care fraud to authorities; Long Term Care Ombudsman Program handling complaints about nursing homes and personal care homes in North, South, West and Center City Philadelphia.

Fees: None
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