• Bereavement Volunteer Contact Report

    Bereavement Volunteer Contact Report

  • Date of Contact*
     / /
    2 digit month, 2 digit day, 4 digit year
  • Contact month:*
  • Date of first attempt phone call:*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Type of Contact:*
  • Date of second attempt phone call
     / /
    2 digit month, 2 digit day, 4 digit year
  • Type of contact:
  • Does the client wish to continue receiving these supportive calls?*

  • Call with any situation that requires immediate attention [607-272-0212]. Submit this contact report to Bereavement Services Administrative Assistant within one week of the call, or by the 5th of the month following the call. Indicate if the client wants to continue to receive calls or not

  • Date*
     / /
    2 digit month, 2 digit day, 4 digit year
  •  
  • Should be Empty: