OCB Therapy Survey
AKA The Situation Report (SITREP). Vets Restoring Vets. This form is recording garage time and therapy sessions of Veterans participating in any of our programs when you visit one of our locations. Indiana, Alabama, and / or California.
Veterans:
Please fill this out at the end of each visit to an OCB facility or event. This is also tracking your shop hours. If you would like your hours to count toward more benefits in our program please remember to fill out this form.
Name
*
First Name
Last Name
Last 4
*
Last 4 numbers of your SSN
Location visited?
*
Day of the week
*
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Reason for your visit?
*
Sunday Shop Day
Personal Project
Lima Charlie - Veteran Peer Support Group
Volunteering
Date of visit:
Time IN & OUT
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
30
Minutes
AM
PM
AM/PM Option
Until
until
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
30
Minutes
AM
PM
AM/PM Option
-"BEFORE" your visit how did you feel?
-"AFTER" your visit how did you feel?
Please let us know what you did here at OCB during your visit. "Your observation". We would really appreciate your comments and also your suggestions. We are always trying to improve our programs.
*
Please give us your feedback
Submit
Should be Empty: