Call Intake Record

A 3-page printable Word log for office staff to record every inbound call to a home care agency.

For USA non-medical home care agency owners and office staff. Plus 1 agency instructions page to remove before use.

What's included

1. Page 1: month, phone line, and the call log with codes for caller type, reason, how they heard of you, and outcome, plus call-back and text consent boxes
2. Page 2: call log continued
3. Page 3: do-not-contact requests log and monthly summary
4. Agency instructions page, to remove before use

Add your logo and name

1. Open the Word file and replace the Your Logo Here box with your logo.
2. Replace Agency Name in the letterhead; the body says "the Agency," so no other name edits are needed.
3. Replace the Street Address, City, State ZIP line and the Phone, Email, Website line with your details.
4. Set the letterhead text to black, delete the instructions page, and save.

Customizable template, not legal advice; check your state's requirements. Not a license to operate, not HIPAA software, and no medical claims. Keep health details and ID numbers off the log. Check federal and state rules on calls and texts.