POST-VISIT FORM

Please complete the form below after every volunteer shift:

Which USVH chapter are you volunteering for?

Name:

First Name

Last Name

Email:

Date of Visit:

YYYY

Time of Visit:

Hour

Minute

Second

Which ward or hallway did you visit during your session?

For each veteran you visited, please fill out the following information:

Veteran Name:

The first veteran you interacted with.

Length of Visit:

Description of Visit:

Level of Participation:

Veteran Name:

The second veteran you interacted with.

Length of Visit:

Description of Visit:

Two to three sentences that include 1) subject of talking 2) positive or negative/frustrated reactions 3) activities involved during the day. Example: "Met with Mr. S and Mr. M for 30 minutes; talked about college, both seemed to have fond memories of anthropology; both seemed positive with many moments of laughter."

Level of Participation:

Veteran Name:

The third veteran you interacted with.

Length of Visit:

Description of Visit:

Level of Participation: