Refuge House Forms Library

Child Name *

Case Number *

Service Package *

?

Select the service package to ensure proper documentation requirements are met.

Contact Date

Contact Time

Phone CallText/SMSIn-Person Visit

Contact Purpose

Person Contacted *

Contact Method

Duration (minutes)

Contact was successful

Voice Note (Simulated)

Conversation Notes *

?

Document conversation details based on service package requirements. Include specific elements as prompted below.

Action Items

Follow-up contact needed

All required documentation is complete and accurateSupervisor review required (crisis contacts only)

Contact Log Entry Form (Draft)