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Washington Regional Medical Center Walker Heart Institute Senior Health Women and Children's Health Total Joint Center

Interact & Connect

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Please complete the form and click send.  In the section titled “Unavailable dates/days to be gone next month,” please list upcoming dates that you will not be available to volunteer.  “Time spent with client” includes your time with the client as well as your driving time to and from the client’s home or other destination(s).  “Miles driven” refers to the distance driven to and from the client’s home and/or other destination(s), if applicable.

Help us stay in touch with our clients by providing comments that the Volunteer Coordinator should or would like to know.  If client is feeling particularly sad, in good spirits, needs additional services, took a special trip or did something of interest, please let us know.

* Indicates required information
Month * 
Volunteer First Name * 
Volunteer Last Name * 
Email * 
Unavailable dates/days to be gone next month 
County * 
Date of Service *   Calendar (mm/dd/yyyy)
Client First Name * 
Client Last Name * 
Time Spent with Client * 
Miles Driven * 
Services Provided * 
Comments 
 


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About Washington Regional

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 Washington Regional
 3215 N. North Hills Blvd.
 Fayetteville, AR 72703
 (479) 463-1000

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Quality and Recognition

Report to the Community
Consumer Choice #1 2012-13
Best Regional Hospitals U.S. News 2011-12
Top Performer Joint Commission 2011
Organ Donation Medal of Honor 2012
Best Hospital CitiScapes Magazine 2012
Celebrate Magazine Very Best 2012
Best of the Best Northwest Arkansas 2012

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