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Volunteer Application

IH Peer Advisor/ Peer Volunteer Application

The Interior Health Peer Inclusion Program aims to improve healthcare for people who use substances by involving the expertise of people who have lived or living experience with substance use. We invite you to bring your voices, perspectives, strengths and skills so we can learn and work together. We welcome experience with substances, including alcohol in the present or the past, either personally or as a loved one. We welcome all lifestyles, backgrounds, gender identities, cultures and ethnicities. We welcome youth ages 12-24 and adults 19+. We highly encourage involvement of people who identify as Aborginal (Indigenous, First Nations, Métis, Inuit).

Personal Information

First Name

Middle

Last Name

* Date of Birth

Address where you can receive mail (honorarium cheques)

Address Line 2

* City

* Province

Postal Code

Personal Phone

Alternative number

Is it okay to leave a message at these number(s)

E-mail Address

Gender you identify with?

Other detail:

What are your prefered prounouns? i.e. She, He, They

Community/Communities you are available to supprt for in person services

Indigenous Self Identification

Interior Health is dedicated to improving Substance Use care for First Nation, Metis, and Inuit care recipients. We acknowledge that this is best achieved through decision making and feedback directly from individuals who identify as First Nation, Metis, and Inuit. For this reason, we ask volunteers if they self identify but emphasize that this information is completely voluntary. There will be absolutely no impact on volunteer opportunities if you do not want to respond.

Indigenous Self Identification

Do you identify as someone who has lived or living experience with substance use including alcohol either personally or by supporting a loved one? (please select all that apply)

By applying for a role as a Peer Volunteer and/or Peer Advisory Group member, you are consenting to identifying as someone with lived or living experience of substance use. At Interior Health, a "Peer" is someone who has a role helping to deliver or plan substance use services or initiatives where their lived experience of substance use is identified and central to their role, which is focused on promoting health and/or reducing harm.

Do you identify as someone who has lived or living experience with substance use including alcohol either personally or by supporting a loved one? (please select all that apply)

Getting Involved

Please select any/all ways you would like to be involved with Peer Inclusion with Interior Health. For descriptions of Peer opportunities please visit Peer Inclusion and Engagement

Interior Health Peer Advisory Group

Interior Health Youth Peer Advisory Group (if you are under 13, you will need parental consent to join)

By choosing either Peer Advisory Group option, your email address will automatically be added to the Peer Advisory email distribution list in order to receive information on various opportunities. Emails to you will come from IHPeerAdvisory@interiorhealth.ca

Interior Health Peer Volunteer: There are limited Peer Volunteer roles, please note that if you select this option we may not have an option available at this time but as opportunities become available you will be notified.

Please consent to the below items (applies to all roles above)

Shared Personal Information Consent:Your personal contact information will be used by Interior Health for the purposes of coordinating, scheduling, and any other necessary administrative and communicative functions relating to IH Peer Inclusion Program.

Consent for Confidentiality Agreement: I consent to learning, understanding and commiting to uphold the confidentiality agreement for my role. I will consider all information in verbal, written, or computerized form, concerning any IH staff, patient, resident, client, family member as confidential. I will not share any confidential information which may come to my attention as a result of my role as a volunteer.

Please consent to the below items only if you are applying for a Peer Volunteer role

Criminal Record Check Consent: Only required for certain Peer Volunteer roles that involve unsupervised access to vulnerable adults. If a criminal record is shown it does not automatically exclude you from particpiating as a Peer Volunteer, the Deputy Registar will determine whether or not there is a risk to working with vulnerable adults. We will support you through this process every step of the way.

Consent to provide proof of Covid vaccination: On October 14 2021, the Provincial Health Officer(PHO) issued a PHO order that requires all staff and volunteers in the health authority to be fully vaccinated (7 days past Dose 2), or have an exemption against the COVID-19 vaccination prior to October 26 2021, in order to work. Proof of vaccine is required if your volunteer role is at an in person service. No proof of vaccine is required for virtual Peer Volunteer or Peer Advisory Group work