Mercy Health Center is a 501(c)(3) non-profit corporation organized and existing under the laws of the State of Georgia whose mission is to provide quality, whole-person healthcare in a Christ-centered environment to our underserved neighbors. Mercy Health Center provides adult medical care, dental care, and behavioral health and wellness services. Mercy Health Center believes that all people should have access to quality healthcare, regardless of their economic status. Persons who meet the following criteria are eligible to be treated at Mercy Health Center: Age 18 and older, Completely uninsured, At or below 200% of the Federal Poverty Level, Residency in one of the following counties: Clarke, Barrow, Jackson, Madison, Oglethorpe, Oconee, Greene, Morgan, Walton, Banks, Franklin, Hart and Elbert.

Volunteer desires to perform activities in support of Mercy Health Center’s mission on a voluntary, unpaid basis (“Volunteer Work”), and Mercy Health Center is willing to accept Volunteer as a volunteer on the terms and conditions set forth in this Agreement.

Volunteer hereby freely, voluntarily, and without duress executes this Agreement under the following terms:

1. Volunteer’s Participation and Status

• Volunteer will perform Volunteer Work on an intermittent schedule determined by mutual agreement of Mercy Health Center and Volunteer.

• In performing Volunteer Work, Volunteer will interact with and take direction from Mercy Health Center staff. Volunteer agrees that Volunteer is not an employee or agent of Mercy Health Center and is not entitled to any compensation or benefits from Mercy Health Center.

• The Volunteer understands that, except as agreed to by Mercy Health Center in writing, the Volunteer is not an employee of, and Mercy Health Center does not carry or maintains health, medical or disability insurance coverage for any volunteer.

2. Conduct of Volunteer

Volunteer will perform all of the Volunteer Work in a manner that will serve to enhance and support the goals and mission of Mercy Health Center as communicated or published by Mercy Health Center. Volunteer agrees to comply with Mercy Health Center’s rules, regulations and policies in effect during the performance of Volunteer Work and as may be changed from time to time. Volunteer agrees to comply with directions given by the Mercy Health Center staff. Volunteer shall provide Volunteer Work in a professional manner consistent with the highest standards of ethical and moral conduct. Volunteer acknowledges that Volunteer has provided information to Mercy Health Center regarding Volunteer’s background, experience and/or skills. Volunteer hereby warrants and represents that all such information provided by Volunteer to Mercy Health Center is true and accurate. Volunteer shall be responsible for any and all problems, costs, damages, claims and liabilities that occur as a result of Volunteer providing incomplete or inaccurate information.

3. Confidentiality / HIPAA

Volunteer understands that confidentiality concerning information pertaining to Mercy Health Center is important and agrees to maintain as confidential information or knowledge gained through performing volunteer services. Generally speaking, all information that is not publicly available or in the public domain is considered “confidential.” The Volunteer agrees to maintain such confidentiality while working as a volunteer and thereafter. Volunteer understands that during the course of performing Volunteer Work at Mercy Health Center, Volunteer may see or hear other confidential information such as financial data and operational information pertaining to the practice that Mercy Health Center is legally obligated to maintain as confidential.

Volunteer understands that Mercy Health Center has a legal and ethical responsibility under the Health Insurance Portability and Accountability Act’s Privacy Rule to maintain patient privacy, including obligations to protect the confidentiality of patient information and to safeguard the privacy of patient information. Volunteer acknowledges receiving HIPAA training and understands the responsibilities of being involved with direct patient care.

Volunteer agrees to not access or view any information other than what is required to perform the Volunteer Work. If Volunteer has any questions about whether access to certain information is required or necessary, Volunteer will immediately ask the Mercy Health Center Privacy Official for clarification. Volunteer will direct inquiries about any and all practice information to the Privacy Official only. Volunteer understands it is not acceptable to discuss any practice information in public areas even if specifics such as a patient’s name are not used.

As a condition of performing Volunteer Work for Mercy Health Center, Volunteer must sign and comply with this agreement. By signing this document Volunteer agrees that any confidential information or patient information that Volunteer accesses or views at Mercy Health Center does not belong to Volunteer. Volunteer will not disclose or discuss patient information and/or confidential information. Volunteer will not make any unauthorized transmissions, copies, disclosures, inquiries, modifications, or purging of patient Information or confidential information. Such unauthorized transmissions include, but are not limited to, removing and/or transferring patient information or confidential information from Mercy Health Center to unauthorized locations. Volunteer agrees that obligations under this agreement regarding patient information will continue after the termination of Volunteer’s assignment/affiliation with Mercy Health Center.

4. Termination of Agreement

Either Mercy Health Center or Volunteer may terminate this Agreement, in whole or in part, at any time with or without cause by giving immediate written notice of termination to the other party.

5. Assumption of Risk

Volunteer understands that the Volunteer Work may involve the risks inherent in providing medical and patient care. Volunteer hereby expressly and specifically assumes the risk of damage, injury, harm or death in connection with the Volunteer Work.

6. Release

Volunteer for and on behalf of himself or herself and the heirs, successors, beneficiaries and assigns of Volunteer, covenants not to sue and does hereby release, forever discharge and hold harmless Mercy Health Center and any person who is the recipient of Volunteer Work, and their respective officers, directors, staff, employees, agents, volunteers, sponsors, heirs, administrators, successors and assigns (the “Released Parties”), from any and all liability, claims, demands and causes of action of whatever kind or nature, either in law or in equity arising out of or relating to (i) Volunteer’s performance or non-performance of this Agreement, (ii) breach of any of Volunteer’s warranties and representations set forth in this Agreement, (iii) Volunteer’s involvement in Mercy Health Center’s projects, including but not limited to the Volunteer Work and (iv) first aid or medical treatment provided to Volunteer in connection with Volunteer Work. Without limiting the generality of the foregoing, Volunteer understands and acknowledges that the foregoing covenant not to sue, release, discharge and hold harmless discharges the Released Parties from any liability or claim that Volunteer may have against a Released Party for bodily injury or property damage, regardless of whether such injury or damage is caused in part by the act or omission of a Released Party. Volunteer agrees that the release, discharge and hold harmless set forth in this Agreement are intended to be as broad and inclusive as permitted by law.

7. Insurance

• Mercy Health Center and the other Released Parties do not assume any responsibility for or obligation to provide or maintain health, medical or disability insurance coverage for Volunteer for injury, illness, death, disability or property damage suffered by Volunteer or third parties.

• Volunteer Healthcare professionals sign a “Volunteer Health Care Provider Agreement” with the Georgia Department of Public Health (DPH) and in turn receive Sovereign Immunity protection. (TITLE 31. HEALTH CHAPTER 8. CARE AND PROTECTION OF INDIGENT AND ELDERLY PATIENTS ARTICLE 8. "HEALTH SHARE" VOLUNTEERS IN MEDICINE (O.C.G.A. TITLE 31 Chapter 8 Article 8)

8. Medical Treatment

Volunteer hereby authorizes each employee and staff member of Mercy Health Center: (1) to act on Volunteer’s behalf in providing first aid and securing medical treatment for Volunteer in the event of injury or illness to Volunteer; and (2) to act on Volunteer’s behalf in accepting financial responsibility (which shall be borne solely by Volunteer) for all first aid and treatment secured for Volunteer. Volunteer understands and agrees that any expense will be Volunteer’s responsibility.

9. Photographs and other Media

Volunteer agrees to allow himself or herself to be photographed or recorded in other media, such as video or audio recordings, in connection with Volunteer Work or other activities or events of Mercy Health Center. Volunteer understands and agrees that the photographs and/or other media recordings may be used to promote Mercy Health Center and its services and events. Volunteer hereby irrevocably grants and conveys unto Mercy Health Center all rights, title and interests in any and all photographic images and other media recordings taken during Volunteer Work or other activities and events of Mercy Health Center, including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or other media recordings. Volunteer understands and agrees that Volunteer is waiving all rights to privacy and ownership regarding the use of such photographs and other media recordings.

Volunteer understands that photographs, videos or any other type of recording of minor children is strictly prohibited while performing Volunteer Work. Volunteer agrees not to take photos, videos or any other type of recording while engaged in Volunteer Work.

10. Mandatory Reporting

The Volunteer understands that any suspected incident of child physical, sexual, or emotional abuse, neglect, exploitation, or deprivation including both child against child and adult against child shall be reported to the local Department of Family and Children Services in accordance with O.C.G.A. Sec. 19-7-5. The Volunteer is to report all suspected incidences immediately to the Mercy Health Center staff or staff member present so a report can be filed. If a Mercy Health Center staff is not in the building at the time, the Volunteer is to ask a staff member to report the incident.

11. Miscellaneous

This Agreement shall be governed by and interpreted under the laws of the State of Georgia without giving effect to its conflict of laws rules. The Volunteer expressly agrees that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Georgia, and that this Release shall be governed by and interpreted in accordance with the laws of the State of Georgia. If any clause or provision of this Agreement shall be held to be invalid by any court, the invalidity of such clause or provision shall not otherwise affect the remaining clauses or provisions of this Agreement, which shall continue to be enforceable. The sole and exclusive jurisdiction and venue for litigation between Volunteer and Mercy Health Center and shall be the Superior Court of Fulton County, Georgia.

By signing below, the Volunteer acknowledges and represents that he or she has read and understands all of the foregoing, hereby execute this Agreement voluntarily, as his or her own free act and deed and that no oral representations, statements or inducements have been made by any of the Released Parties in connection with this Agreement. Volunteer Volunteer Agreement 2025