CO Healthcare Corps Employer Interest Form
To help serve Coloradans and meet vital healthcare needs, Serve Colorado, Governor Polis, and the Colorado Department of Public Health and Environment have partnered on the creation of the Colorado Healthcare Corps, an AmeriCorps program. Our goal is to demonstrate success with this AmeriCorps pilot and ultimately integrate operations with the well established Colorado Health Services Corps within the Health Access Branch at the Colorado Department of Public Health and Environment.

Approximately 150 individuals will be recruited to serve as skilled AmeriCorps members at interested healthcare facilities across Colorado. To host a member, a facility must be an institution of higher education, local government, nonprofit organization, or Tribal government.

Facilities may determine what member role, requirements, and schedule will look like, including:
                       - Experience or previous education (e.g., licensed CNAs);
                       - Health Corps member schedule (2-3 days per week to full-time); or
                       - Health Corps member term of service (e.g., 3 months to 1 year).

Health Corps members will receive compensation from the program for their service including a living allowance, housing stipend, healthcare and childcare benefits, and an AmeriCorps education award to repay student loans or to put towards future education expenses.

If you are interested in hosting a Healthcare Corps member(s), please complete the form below. We will follow up with you with more information. If you have questions about hosting an AmeriCorps member, please email servecolorado@state.co.us.

Thank you for your interest in hosting a Healthcare Corps member!
Sign in to Google to save your progress. Learn more
Facility Name *
Where are you located? (city/county) *
Facility Type *
Facilities must be an institution of higher education, local government, nonprofit organization, or Tribal government.
Contact Person Name (First & Last) *
Contact Person Phone Number *
Contact Person Email Address *
What position type are you interested in? *
Please check all position types that apply.
Required
How long would you be interested in having members serve at your facility? *
Please check all that apply, if you are flexible please indicate in the 'other' option.
Required
What healthcare roles are you interested in hosting? *
Please check all positions of interest.
Required
How many members would you be interested in hosting? *
Is there someone at your facility that can provide on-site supervision to members? *
Supervisor needs to provide at least 1 hour of supervision (1:1 or in group format) to members as well as provide support/coaching as needed with day-to-day responsibilities.
Do you have a computer available for a member to use for daily work, training, timesheets, etc? *
Please provide any additional information below.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of State.co.us Executive Branch. Report Abuse