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PINE TREE HOSPICE
VOLUNTEER TIMESHEET
INDIRECT CARE
VOLUNTEER:
MONTH and YEAR:
PTH licensure
REQUIRES
documentation of volunteer services
Do
NOT
include attendance at Committee or Team meetings; these hours are recorded at the meeting
A separate form is used for Continuing Education
Please scroll down to see a list of services
PLEASE enter your time in 1/4 hour segments using decimals (for example, 2.
25)
DATE
DESCRIPTION OF SERVICE OR EVENT
HOURS
TRAVEL
TOTALS:
DESCRIPTION OF SERVICES INCLUDE:
(please specify what the "activities" are)
Adult Bereavement Indirect Activities
Hospice Committee Activities
Board Development Activities
Nights of Service Indirect Activities
Board Executive Activities
Office Work
Board of Directors Activities
Public Relations
Bereavement Committee Activities
Regional Team Activities
Education Committee Activities
Other (Please Specify)
Finance Committee Activities
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