WOMEN’S HOPE MEDICAL CLINIC

Client Advocate Application

The following application is the first step in becoming a client advocate at Women’s Hope
Medical Clinic. You will also meet with the Client Services Director and attend training to
better equip you in this specific ministry.

The application is somewhat lengthy, but only to help you understand the ministry of Women’s
Hope Medical Clinic more thoroughly and to help you decide if this is where the Lord has called
you to serve. It is not used to grade applicants or compare with other volunteers. We recognize
God uses many types of people from many different backgrounds to complete His kingdom.
Please take your time as you complete each question prayerfully.

We are seeking women & men who have a firm, dedicated commitment to the Lord and who will
make themselves available to Him, not necessarily “spiritual giants” or those who seem to have
never experienced anything troubling in their lives. If you have an ability to stick with
commitments that you make and have a genuine desire to help women, men, and families facing
unplanned pregnancies and other difficult life situations, this may be where God is leading you!

It is extremely important that your walk with the Lord is growing, but have no doubt that your
faith will increase as you serve Him here. There will be times when you know your Heavenly
Father has worked mightily through you; in these times you will be absolutely amazed at His
ability to change hearts. The Lord may use you to bring someone to know their salvation in
Jesus Christ, or perhaps to save a mother and child from the choice of abortion. These moments
will change your life, and you will never forget the wonderful things you experienced while
volunteering.

But to be honest, there will also be times when you feel frustrated or defeated. There may be
times when you feel as if what you are doing is not making a difference. This is exactly how
Satan wants us to feel, so that we will give up and just quit trying. Guard yourself from this, and
remember that in good or hard times God’s hand is never idle! You must have faith and know
that the Lord is at work in the hearts of those with whom you meet, even when you don’t see the
results.

We are not asking that you have all of the answers, or that your relationship with the Lord be
always what you would want it to be. We are asking for openness to the calling of God to be
used by Him. We are asking for women & men who are willing to make the commitment
necessary to nurture their relationship with the Lord and who will go the extra mile to love and
care for women & men in need in our community. If you feel this may be where God is calling
you to serve, we have been praying that you would pick up this application. In the pages ahead,
we hope you will find confirmation of His call to be part of this ministry. God bless you!
 WOMEN’S HOPE MEDICAL CLINIC
Mission, Vision & Core Values

The mission of Women’s Hope Medical Clinic is twofold: First, Women’s Hope Medical Clinic is a
Christian ministry dedicated to meeting the physical, emotional and spiritual needs of those facing an
unplanned pregnancy. Second, Women’s Hope Medical Clinic promotes the sanctity of human life and the
benefits of healthy relationships and sexual integrity.

At Women’s Hope Medical Clinic, our vision is more than just to help people through a crisis situation. We
want to meet individuals where they are, then empower and equip them to make vital progression in their
lives. We encourage them to make lasting changes that will lead to physical, emotional and spiritual
wellness.

Core Values:
1. WHMC values the spiritual truth found in God’s holy inspired Word, the Bible.
We will uphold the laws of God and the Lord Jesus Christ in words as well as deeds.
(2 Tim. 3:16, 2 Peter 1:20-21)
2. WHMC values each individual as having worth and intrinsic value given by God.
Because of this, we will seek to meet the physical, emotional, moral, social and spiritual needs of
women, men and families facing unplanned pregnancies and other crisis situations. (Psalm 139:14,
Ephesians 2:10)
3. WHMC values diversity as a by-product of our Maker’s creativity.
Therefore we will not discriminate regarding race, religion, creed, national origin, age or marital
status. (Acts 10:34-35, Romans 2:11)
4. WHMC values the sanctity of human life from conception.
We will not advise, provide or refer for abortion or abortifacients. (Jeremiah 1:5, Psalm 139:13)
5. WHMC values putting our faith into action to help meet people’s practical needs.
We will seek to help clients with necessary resources by securing practical solutions by arranging
medical, legal and all manner of social services. (James 2:15-17, Matthew 25:34-40)
6. WHMC values the biblical institution of marriage.
We will seek to teach and develop God’s design for covenant marriage, which has
implications for love, dating, sex and family. (Genesis 2:24, Ephesians 5:22-33)

7. WHMC values the practice of respecting all people.

We will honor our clients by providing complete privacy and confidentiality. (Philippians 2:3-4,
Matthew 7:12)
8. WHMC values the example of service demonstrated through the life of Jesus Christ.
We will seek to demonstrate the love, compassion and forgiveness that Jesus did by providing
education, action and creative services for all of our clients. (Matthew 14:14, Matthew 18:33)

9. WHMC values salvation by grace through faith in Jesus Christ.

We will take advantage of every opportunity to share the good news of Jesus and seek to lead each
client to a personal relationship with Him. (Ephesians 2:8-9, Titus 3:5, Romans 10:10, 13)

10. WHMC values honesty and integrity in every aspect of work and life.
 WOMEN’S HOPE MEDICAL CLINIC
We will always give our clients open and truthful answers and provide them with accurate
educational and medical information. We will also use advertising and communications that are
honest and truthful and accurately describe the services we offer. (Exodus 20:16, Psalm 15:1-2)

Statement of Faith

1. We believe the Holy Bible to be the only infallible, inspired authoritative Word of God (II Timothy
3:15-16, II Peter 1:20-21)

2. We believe in God eternally existing in three persons: Father, Son, and Holy Spirit (I John 5:7-8,
Deuteronomy 6:4-5, Matthew 28:19, II Corinthians 13:14)

3. We believe that Jesus Christ is the only begotten Son of God, conceived by the Holy Spirit, born of
the Virgin Mary, and is true God and true man (John 1:1-14, Luke 1:34-35, I John 4:9)

4. We believe that mankind was created in the image of God; that mankind sinned and thereby incurred
not only physical death, but also spiritual death, which is separation from God; and that all human
beings are born with a sinful nature (Genesis 1:26, Romans 5:12, Ephesians 2:1)

5. We believe that the Lord Jesus Christ died for our sins according to the Scriptures as a representative
substitutionary and complete sacrifice; and that all who believe in Him are justified on the ground of
His shed blood (Romans 5:8, Galatians 1:4)

6. We believe that for the salvation of lost and sinful man, regeneration by the Holy Spirit is absolutely
essential, and that salvation is received by grace through faith in Jesus Christ as Savior and Lord and
not as a result of good works (Titus 3:5, Ephesians 2:8-9)

7. We believe in the physical resurrection of the crucified body of Jesus Christ, in His ascension to
Heaven and His present life there for us as our High Priest and Advocate (Hebrews 1:3, 4:15-16,
I John 2:1)

8. We believe in the personal, visible, and second coming of our Lord Jesus Christ, at a time unknown
to us, but for which we are watching joyfully (I Corinthians 15:51, I Thessalonians 4:13-18)

9. We believe that the believer should be a vessel sanctified, fitting or proper for the master’s use (II
Timothy 2:21, I Thessalonians 4:3)

10. We believe in the great commission which our Lord has given to His church to evangelize the world,
and that this evangelization is the great mission of the church. Furthermore, we believe it our
Christian duty to witness by word and deed to these truths (Matthew 28:19-20, II Corinthians 5:11)

11. We believe in the bodily resurrection of the just and the unjust, the everlasting conscious punishment
of the lost, and the everlasting blessedness of the saved (John 6:40, Acts 24:15, II Corinthians 4:14)

12. We believe in the spiritual unity of believers in our Lord Jesus Christ (Ephesians 4:13, Romans 12:5)
 WOMEN’S HOPE MEDICAL CLINIC

Our Commitment of Care

1. Clients are served without regard to age, income, nationality, religious affiliation, disability or other
arbitrary circumstances.

2. Clients are treated with kindness, compassion and in a caring manner.

3. Clients always receive honest and open answers.

4. Client pregnancy tests are distributed and administered in accordance with all applicable laws.

5. Client information is held in strict and absolute confidence. Releases and permissions are obtained
appropriately. Client information is only disclosed as required by law and when necessary to protect
the client or others against imminent harm.

6. Clients receive accurate information about pregnancy, fetal development, lifestyle issues and related
concerns.

7. We do not offer, recommend or refer for abortions or abortifacients, but we are committed to offering
accurate information about abortion procedures and risks.

8. All of our advertising and communications are truthful, honest and accurately describe the services
we offer.

9. We provide a safe environment by screening all volunteers and staff interacting with clients.

10. We are governed by a board of directors and operate in accordance with our articles of incorporation,
by-laws, and stated purpose and mission.

11. We comply with applicable legal and regulatory requirements regarding employment, fundraising,
financial management, taxation, and public disclosure, including the filing of all applicable
government reports in a timely manner.

12. Medical services are provided in accordance with all applicable laws, and in accordance with
pertinent medical standards, under the supervision and direction of a licensed physician.

13. All our staff, board members, and volunteers receive appropriate training to uphold these standards.
 WOMEN’S HOPE MEDICAL CLINIC

At the end of this application you will be asked to sign that you agree
with the above documents. (Mission & Vision Statements, Core
Values, Statement of Faith, and the Commitment to Care)
Please keep these above documents as a reminder to you of what
commitment you have made to Women’s Hope.
Please fill out the following sheets and return them to the
Client Services Director.
 WOMEN’S HOPE MEDICAL CLINIC

Women’s Hope Medical Clinic

Client Services Director
820 Stage Rd.
Auburn, AL 36830

Client Advocate Application

Volunteer Name: ________________________________________________________________________

Contact Information:
Phone: (H) ______________________ Address: ___________________________________________
(C) ______________________ ____________________________________________
(W) _____________________ ___________________________________________
Birthday: ___________________ E-Mail: ___________________________________________
Areas of Interest:
• Client Advocate Receptionist Clothes Closet
• Prenatal Clinic STD Clinic Post-Abortion Recovery
• Walk for Life Banquet Office Help/Mailings, etc.
• Other Talents & Gifts: _______________________________________________________________
_______________________________________________________________
_______________________________________________________________
How did you hear about us: _______________________________________________________________
Church: _______________________________________________________________________________

FOR OFFICE USE ONLY

Status of Volunteer: Notes:
Date of First Contact: ___________________ _______________________________________
Date Application Sent: ___________________ _______________________________________
Application Received: ___________________ _______________________________________
Date of Interview: ___________________ _______________________________________
References Sent: ___________________ _______________________________________
References Received: ___________________ _______________________________________
Completed Training: ____________________ _______________________________________
Background Check: ____________________ _______________________________________
 WOMEN’S HOPE MEDICAL CLINIC
Commitment Signed: ____________________ _______________________________________
Orientation Completed: ____________________ _______________________________________
Active Volunteering: _____________________ _______________________________________

Inactive/Reason: (Date: ________________________)

_______________________________________________________________________________________
_______________________________________________________________________________________
Personal Information:
Marital status: Married Single Divorced Widowed
Spouse’s name: _________________________________________________________________________
Children’s names & ages: ________________________________________________________________
_______________________________________________________________________________________
Occupation & Employer: _________________________________________________________________
Do you have any physical limitations (please specify): _________________________________________
_______________________________________________________________________________________
Does your family/spouse support your decision to volunteer with WHMC? Yes No
If no, please explain: ______________________________________________________________________
Educational/Vocational Background:
Graduated High School: Yes No
Graduated College: Yes No * If still in college, estimated Graduation Date is: _____________
Special qualifications (advanced degree, counseling experience, etc.): ____________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Field of working experience: ______________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Previous Volunteer experience: ____________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Why would you like to be involved with WHMC? ____________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Are there any personalities, socio-economic backgrounds, or members of the opposite sex with which
you may have difficulty working? Yes No If yes, please explain: ________________________
 WOMEN’S HOPE MEDICAL CLINIC
_______________________________________________________________________________________

We ask that our volunteers commit to a minimum of four shifts each month for at least a year. A shift
is either morning (9:00am -12:00pm) or afternoon (1:00pm-5:00pm). Also, we ask that you attend a
minimum of 2 out of 4 in-services a year. Are you willing to make this commitment? Yes No

Spiritual Background:
In your opinion, how does a person become a Christian? _______________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

Personal Testimony:
Before I had a relationship with Jesus Christ, I lived and thought this way: _______________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

This is how and when I accepted Jesus Christ as my personal Lord and Savior: ___________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

After my conversion experience, these changes took place in my life: _____________________________

_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
 WOMEN’S HOPE MEDICAL CLINIC

Pertinent or Favorite Bible verse: __________________________________________________________

_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

Additional Questions:
In your own words, what is client advocacy? _________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
How do you evaluate your emotional stability? _______________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Please list a few of your strengths and weaknesses? ___________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Have you ever received personal evangelism training? Yes No If yes, please explain when,
where, and in which program you participated: _________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Have you had other experiences or training you feel would be of value to you in helping women, men,
and families facing unplanned pregnancies or other difficult life situations? ______________________
_______________________________________________________________________________________
_______________________________________________________________________________________
How do you feel about abortion as an option for a woman or man facing an unplanned pregnancy?
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
How do you feel about adoption as an option to a woman or man facing an unplanned pregnancy?
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
How do you feel about a mother or father facing an unplanned pregnancy deciding to parent, even if
unwed? ________________________________________________________________________________
 WOMEN’S HOPE MEDICAL CLINIC
_______________________________________________________________________________________
_______________________________________________________________________________________
What is your personal view on sex outside of marriage? _______________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

What is your personal view on birth control? ________________________________________________

_______________________________________________________________________________________
_______________________________________________________________________________________
Would you be comfortable promoting abstinence only for unwed clients? _________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Briefly describe how you would assist a woman or man facing an unplanned pregnancy: ___________
_______________________________________________________________________________________
_______________________________________________________________________________________

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The following will in no way disqualify you from being a volunteer!!! Many of our volunteers have
faced difficult and challenging situations and the Lord has used them to minister to others through
this ministry. However, we do strongly encourage that counseling be sought for complete healing
before serving as Client Advocate. We have several contacts that offer various types of counseling in
these areas. We can also offer counseling for post-abortion healing through our G.R.A.C.E. Recovery
& Support group.

Have you experienced one or more of the following situations: Yes No

Please check all that apply. Unplanned Pregnancy Pregnancy Termination
Sexual Abuse/Assault Addiction to Illicit Behavior Other ___________________________
Please explain: __________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Have you been through any type of counseling for any of the above situations? Yes No
Please explain what type: __________________________________________________________________
_______________________________________________________________________________________
Do you feel that you can use this experience in helping clients facing the same situation?
Yes No Please explain how: _______________________________________________________
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_______________________________________________________________________________________
_______________________________________________________________________________________
Do you feel that any of these situations/experience would hinder you in any way in volunteering here
at Women’s Hope? Yes No Please explain how: _______________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

References:
***In order to become a volunteer for this ministry, we ask that you provide references from a pastor/youth
minister/college minister, etc. (either locally or from your “home” church) and one other person who has
known you for at least one year and to whom you are not related.
Please fill out ALL information below:

Pastor’s Name___________________________________________________________________________
Address________________________________________________________________________________
City, State, Zip___________________________________________________________________________
Phone__________________________________________________________________________________

Name__________________________________________________________________________________
Address________________________________________________________________________________
City, State, Zip___________________________________________________________________________
Phone__________________________________________________________________________________

By signing here, I certify that I have read and understand the above
information. I further understand that an inquiry may now be made which
will provide information regarding my character, general reputation,
and relationship with Jesus Christ. I am also in agreement with the above
principles and doctrinal statements, and if at any time there is a change in my
beliefs, I shall immediately make it known to the Client Services Director.

By signing here, I also certify that I will uphold my commitment to

volunteering four times a month for at least one year. (Unless other
arrangements have been made with the Client Services Director)
 WOMEN’S HOPE MEDICAL CLINIC
If at any time there is a reason I cannot uphold this commitment I
shall immediately make it known to the Client Services Director.

_____________________________________________ _______________________
Signature Date

APPLICANT’S CERTIFICATION AND AGREEMENT

I certify that the facts set forth in this application are true and complete to the best of my knowledge, and I
authorize the medical clinic to verify their accuracy and to obtain reference information concerning my character and
capabilities. I release the medical clinic and any person or entity providing such reference information from any and
all liability relating to the provision of such information or relating to any decisions made based upon such
information. I give permission to the clinic to conduct a criminal background check as my duties may involve direct
interaction with minors. If I become a volunteer/employee at the medical clinic, I agree to fully adhere to its policies
and rules, including those rules relating to maintaining client confidentiality. I recognize that if I am a volunteer, I will
serve in a different role than the employees of the medical clinic, and I am not seeking, nor expecting to receive, any
compensation or other benefits in return for any volunteer services which I may provide for this ministry.
I further certify that I have read and that I am in full agreement with Women’s Hope Medical Clinic’s
Statement of Faith and Statement of Principle.

Signature _______________________________________________________ Date ___________________________

CERTIFICATION OF
UNDERSTANDING ON CONFIDENTIALITY

I understand that while I am employed at Women’s Hope Medical Clinic I may see or hear information which is
considered confidential.

I understand the following information will be considered confidential:

a. Any information included in medical records or charts, including case

histories and patient’s diagnoses.
b. Any financial information regarding our company, its accounts, or our customers.
c. Any human resource records of applicants or former employees.
d. Social Security numbers or addresses of employees or customers.

I understand that the above information is available only to those employees who need the information to conduct
Women’s Home Medical Clinic’s business. This information is not to be given even to family members of the patient
unless we have specific permission from the patient themselves (anyone 14 years or older). I also understand that it
will be considered a violation of company policy to request or access information which I know is not needed in order
for me to conduct the business for which I am employed.

I understand that Women’s Hope Medical Clinic agrees to maintain the confidentiality of the above information and
that I am PROHIBITED from disclosing any such information unless required by my specific job duties and then only
in the course of normal business and only to those who have a need to know. The single exception to this policy is
when I am given specific instructions by my manager to disclose such information.
 WOMEN’S HOPE MEDICAL CLINIC
By signing here, I certify that I have read and understand the above information. I further understand that a violation
of the confidentiality of any of the above information can result in my immediate termination as an employee/volunteer
of Women’s Hope Medical Clinic.

Signature _______________________________________________________ Date ___________________________

Dress and Appearance

All persons who serve at Women’s Hope Medical Clinic should reflect professionalism. Therefore, all
employees and volunteers are expected to dress appropriately, with attention to the message their attire
communicates. Employees and volunteers should dress in a manner appropriate for a professional office.
While it is important not to dress in a manner that would intimidate clients, the attire of employees and
volunteers should reflect competence, neatness and a professional demeanor. Jeans, casual shorts, and
revealing attire are not appropriate during regular office hours. Dresses and skirts should be no shorter than
two inches above the knee. Spaghetti straps or halter tops cannot be worn. The Director will be responsible
for evaluating the propriety of office dress and appearance.