Volunteer Name*
Volunteer Phone*
Client's Firstname*
Client's Surname*
Dates and Times of Visits*	eg. 22-08-2008 eg. 2 - 4:30pm Delete Add extra visit date
Total Time Spent (Both boxes!)*	hrs : mins
Total KMs Travelled*	km
Activities of Care*	Companionship Shopping Cooking Chatting Walking Personal Care Driving Housework Reading Childcare Massage Reiki Counselling Music therapy Art therapy Games, TV Biography Gardening Meditation Yoga
General Report about Client and/or Family*
Any Extraordinary Developments
Caregiver's Thoughts/Feelings*
Overall Relationship with Client*	Good Needs Improvement
Requested Response/FollowUp*	Urgent When able Not necessary
(* Required fields)