Name of Volunteer

Month

Name of Senior You Visited Client #1

Date(s) of Visit(s)

Type(s) of Visit(s) (in-person, phone, video)

Total Hours Visited This Month

Brief Summary of Visit

Name of Senior You Visited Client #2

Date(s) of Visit(s)

Type(s) of Visit(s) (in-person, phone, video)

Total Hours Visited This Month

Brief Summary of Visit

Name of Senior You Visited Client #3

Date(s) of Visit(s)

Type(s) of Visit(s) (in-person, phone, video)

Total Hours Visited This Month

Brief Summary of Visit

Name of Senior You Visited Client #4

Date(s) of Visit(s)

Type(s) of Visit(s) (in-person, phone, video)

Total Hours Visited This Month

Brief Summary of Visit

Name of Senior You Visited Client #5

Date(s) of Visit(s)

Type(s) of Visit(s) (in-person, phone, video)

Total Hours Visited This Month

Brief Summary of Visit

Name of Senior You Visited Client #6

Date(s) of Visit(s)

Type(s) of Visit(s) (in-person, phone, video)

Total Hours Visited This Month

Brief Summary of Visit