Volunteer's Monthly Report

Volunteer's name:	Month/Year:
Friend's name (first name and last initial only):
or Group placement (if applicable):
Hours spent visiting with your friend:	Number of visits:
Hours spent on the phone with your friend:	Number of phone calls:
Briefly describe the activities in which you and your friend participated this month (movies, museums, watching TV, eating out, visiting with others, Compeer events, etc.):



Do you have any questions, concerns, or good news about your friend, your relationship with your friend, or your group placement?



Please note here any changes in your address/phone number, your friend's address, phone number, or therapist, or your group's location or coordinator:



Has your friend been admitted to a psychiatric hospital in the past month? If yes, please list the date and hospital here:

Has your friend been discharged from a psychiatric hospital in the past month? If yes, please list the date and new address here (if your friend has moved):

Do you have any concerns about your friend's condition?


Do you want a volunteer coordinator to call you?	_____ Yes _____ No
Do you want your friend's therapist to call you?	_____ Yes _____ No
Your home phone: Your work phone: Best time to call:
Additional comments: