Virtual Visit Feedback Submission Required within One Week of Call Virtual Visit Feedback Form Thank you for volunteering with Conversations to Remember. Please complete and submit this form each week after you have completed your virtual visit. We use this information to track your volunteer hours, which will allow us to certify your hours should you need that at any time in the future. Also, please let us know if there were any technical problems on your call, or if anything occurred during your virtual visit which concerns you.Volunteer name Volunteer email Date of visit Name of senior you visited with What other volunteers were on the call today? Volunteers will receive a minimum of one hour of community service for each call, as long as they arrived on time, and were prepared to stay for a full hour. If the call lasts longer than an hour, volunteers should take community service credit for the actual length of the call. Please report the community service hours you're claiming, as well as the amount of time that the senior was actually present on the call.Volunteer community service (in hours) -Select-0.50.751.01.251.51.752.02.252.5Senior time on call (in minutes) What support did you need on this call (check all that apply, and provide details below): Senior did not immediately get on the call Senior disconnected during the call Senior could not see us Senior could not hear us I could not see senior I could not hear senior Senior never got onto the call Other - specify in below boxDetails of technical problems Please provide us with any positive or negative feedback about your virtual visit, or just tell us about the call. Is there anything that Conversations to Remember can do to help you with future virtual visits with this senior?Need assistance -Select-YesNoHow can we help? Please confirm that you will be having your virtual visit with this senior again next week. Note: we request that you contact Eve with 3 weeks notice of the date when you will be permanently leaving the visit to give us adequate time to transition.Confirmation -Select-Yes, I'll be thereNo, I will not be there next weekSubmit
