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Unformatted text preview: HOME VISIT REPORT
(Please save the Home Visit Report as a Word Document before sending) Date of Visit: Your Name: Your Email: Your Phone Number: Your Family's Phone Number: Names, ages and relationships of family members present at this visit: Name Age Relationship How do you rate the following:
1. Your team's communication with volunteer family on this visit? Excellent Good Fair Poor 2. Your team's communication over setting time and date for visit? Excellent Good Fair Poor 3. Communication between team members and family during the visit? Excellent Good Fair Poor 4. The level of teamwork in your student team in planning the visit (i.e. scheduling visit, planning who would do what, completing assigned tasks)? Excellent Good Fair Poor 5. The team members' collaboration/participation during the visit? Excellent Good Fair Poor 6. What is your overall rating of this home visit? Excellent Good Fair Poor NEXT PAGE Were there any problems with this home visit that concern you? (For example, any problems with scheduling the visit, with the conduct of the team during the visit, the assignments, problems with any particular family members, concerns about your safety, etc.) Write a few sentences about the following: The most important things you learned about the family during this home visit (e.g., attitudes about health and the health care system, social support, affects of illness on the family system, their quality of life. etc.). Your impressions of how your team functioned during the home visit. Any other general impressions you came away with. ...
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This note was uploaded on 07/01/2011 for the course BMS 6828 taught by Professor Davidson during the Fall '10 term at University of Florida.
- Fall '10