Arts and Healing Visitor Program

Guidelines

To provide a positive experience for special visitors, patients, and families at OSF Saint Francis Medical Center and Children’s Hospital of Illinois, the following guidelines have been established and must be met in order for your application to be considered. All special visitors must review these guidelines, and this form must be signed by each member of the group.

All the members of the group must be at least 14 years of age to perform in the medical center lobby, 16 years of age to also perform in a patient care unit and at least 18 years of age to perform in the pediatric and ICU areas.
Group performances are limited to a total of 8 persons in the lobby and 2-3 individuals in a patient care unit.
Visitors to the medical center must be healthy. Group leaders are responsible to ensure that all members have not had a cough, cold and/or fever in the 24 hours prior to visit, or exposure to any communicable diseases such as measles, mumps, or chicken pox within three weeks prior to visit.
All group members will respect patient confidentiality. Information gained during the visit must NOT be discussed or shared outside the hospital.
All group members will follow directions of Volunteer Services with respect to performance area.
Photographs are not encouraged due to confidentiality. Special arrangements are required and must be discussed with Volunteer Services prior to the visit.
Special visitors assume all responsibility for personal belongings and equipment. The hospital is not liable for loss or damage.
Visits are not guaranteed. Scheduling is based on staff availability and patient census. We will make every effort to accommodate your visit.

* indicates a required field.

* Name:
* Address:
* City:
* State:
* Zip:
* Phone:
* Best Time To Call:
Email:
Group Name:
Number in Group:	(Refer to guidelines for group limits.)
* Services:	Description of services (ex. music, beauty, massage, etc.) to be provided to patients. Please be specific.
* Benefits:	How will the patients benefit from your visit?
* Date of Visit:	When are you interested in visiting?
* Agreement:	I verify that I have read and agree to follow all Arts and Healing visitor guidelines. I understand that each member of the group will be asked to sign this form on the day of visit prior to providing services.

We respect and safeguard your privacy. This form is secure.