Chaplain's
Activity Report Form

WordAlone Chaplains are requested to fill out this short form upon completion of each client session. The contents of this form will be primarily used to gauge the success of the Chaplain Corps program. Its secondary benefit will be provide you, the "boots on the ground" so to speak, valuable insight on how your compatriots are dealing with issues they are confronted with.

Anonymity is assured in that client names are not collected. All that is required of you is to complete one of these forms upon resolution (or not) of a client issue.

INSTRUCTIONS

The drop-down boxes and the "Time Devoted" box must not be left blank. The two text-entry boxes (2nd line) are open for you to input (1) a client issue and (2) the resolution you arrived at. Thank you!

Login (e-mail address)