Volunteering

Application for Volunteer Membership

If you would like to be a part of this worthwhile program, you can apply using the form below. If you would like more information, please call the Volunteer Services Office of Brookhaven Memorial Hospital Medical Center at 631-654-7737.

If you are currently a student please use the Application for Junior Volunteer Membership.

* Required Information

Personal Information

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Cell


Please check all areas of service you are interested in:

Please specify the times you are available each of the following days:
Morning Afternoon Evening
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Education
You must be at least 14 years of age to apply.

In Case of Emergency, notify:

Physician:
Hospital News View All

May 20, 2016
Spotlight on Children 16th Annual Golf Outing

Spotlight on Children 16th Annual Golf Outing Honoring Richard T. Margulis

May 16, 2016
National Nurses Week

National Nurses Week is an opportunity to recognize the nursing team at BMHMC

May 09, 2016
United Hospital Fund's 2016 - Distinguished Trustee Award

Michele Knapp

May 03, 2016
Congratulations MaryAnne Cornell - Volunteer of the Year!

2016 Volunteer Luncheon