Seacoast Hospice

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1-800-416-9207

Volunteer
Trained Hospice Volunteers
Become A Volunteer
Volunteer Newsletter
Past Issues
Report Volunteer Hours

Submit Your Hours

Volunteer's Name: Mr. Ms. Mrs. Miss

Help Volunteer's Email:

Date of Service

Patient
(used only for direct service)

Activity Code

Duration
(hours)

Activity Codes

Code	Direct Patient Care	Code	General Support
101	Direct Care	301	Board of Directors
102	Bereavement – group facilitating and/or mailings	302	Ethics Council
102A	Bereavement – specific to contact with family/friends of the deceased in person	303	Fundraising
102B	Bereavement – specific to contact with family/friends of the deceased by phone only	304	Public Relations – includes BOATING, Speech Corps, and assistance at various info fairs.
		305	Projects – gardening, labyrinth, other projects.
	Patient Care Support
201	Administration – includes clerical office tasks, library, data entry.

Hyder Family Hospice House – please use weekly sign in at HFHH for all activities. DO NOT use this sheet or the online form to report any HFHH hours.

Notes/Comments:

Thank you for reporting your MONTHLY hours by the 5th of the following month.

To report your hours, you can do one of the following:

On-line
Report your hours on-line.
On-line Form

Email
Send an email to the Coordinator of Volunteers: volunteers@seacoasthospice.org

Mail
Download a printer-friendly Hours Form.
Hours Form

Mail your Hours Form to:
Coordinator of Volunteers
10 Hampton Road
Exeter, NH 03833

Phone
Call a Coordinator of Volunteers at
1-800-416-9207.

X Directions for Completion of Time Sheet

Name: First and last

Email: So we can reply and update records if necessary

Date of Service: Month/Day/Year of each visit or service provided

Patients: First and last name of each patient for every visit

Activity Code: Explains the nature of your visit or service for ease of entry into the computer system

Code	Direct Patient Care	Code	General Support
101	Direct Care	301	Board of Directors
102	Bereavement – group facilitating and/or mailings	302	Ethics Council
102A	Bereavement – specific to contact with family/friends of the deceased in person	303	Fundraising
102B	Bereavement – specific to contact with family/friends of the deceased by phone only	304	Public Relations – includes BOATING, Speech Corps, and assistance at various info fairs.
		305	Projects – gardening, labyrinth, other projects.
	Patient Care Support
201	Administration – includes clerical office tasks, library, data entry.

Duration: Amount of time, including travel time to and from your visit(s) or activity. Please submit time in 1/4 hour increments. (Ex.: 2.75 hours, 3.25 hours) Includes ALL work done on behalf of Seacoast Hospice.

Thank you for your time, and for your prompt reporting by
the 5th of the month following your last volunteer work.

10 Hampton Road, Exeter, NH 03833

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