Resources > Chaplain Hours Record
______________________________________

Chaplain Hours Record

Chaplain Hours may now be submitted online here.
Please complete the following information and click "submit" when completed.

Month
Patient ID# (Do not type name)
Chaplain Name

Chaplain Services Provided:
Prayed with pt.
Discussed closure with pt./family
Counseled concerning spiritual issues
Reviewed life events
Read from Bible or
Counseled about family concerns
Communion with pt.
Other   
please describe
 
Date




Comments




Mileage




From




To




 

 

Submit online
forms here

Volunteer Hours Record

Chaplain Hours Record

Download printable PDF
Volunteer Application here

Volunteer Application

Download printable PDF
Employment Application here

Employment Application

_________________

- Other Resources -

Click on the logos to go
to their websites

_________________

To download a state-specific
living will or healthcare power
of attorney, visit this site.