Ride Along Companion Volunteer

Roanoke, VA
Volunteer Opportunities /
Volunteer /
On-site

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Ride Along Companion Application

  • 1. Are you 18 years or older?
  • 2. What is your current Occupation?
  • 3. Shifts for this role are on-call, meaning that you can stay home until you receive a call from us. Shifts are Thursdays and Fridays 10am-3pm. Are you available during these time periods?
  • 4. Do you have a reliable way of getting to the clinic when called?
  • 5. Why are you interested in being a Ride Along Companion?
  • 6. Please share any previous applicable volunteer experience, or experience with a reproductive health care provider you have.
  • 7. Please describe any accessibility needs that you would like us to be aware of.
  • 8. Please select where you learned about this volunteer opportunity:
  • If you selected Other, please tell us where:
  • If you were referred by a PPSAT employee, please enter their name below.
  • 9. I have given Planned Parenthood South Atlantic true and complete information on this application. I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give Planned Parenthood South Atlantic permission to contact previous employers, references, and others, and hereby release Planned Parenthood South Atlantic and its employees, directors and officers from any and all liability as a result of such contact. I acknowledge that all volunteerism at Planned Parenthood South Atlantic is at-will. I understand that volunteering with Planned Parenthood South Atlantic is contingent upon a background check that may include sex offender registry, social media accounts, and general reputation.