Welcome to your Telephone Reassurance Script

Today's Date

Time Started

Staff Member:

Agency:

Phone Number Called:

How are you? How is everyone doing?

Any changes since last time we talked?

1. Has there been any changes in the health of any of the members of your household.

2. Has there been any concerns about nutrition and getting meals?

3. Has there been any concerns about hydration of members of your household?

4. Are the members of your family sleeping normal?

5. Do you and the members of your household have enough of your prescription medication to last 2 weeks?

6. Have anyone in your family become ill with fever, sore throat, runny nose or cough?

7. Is the client shown any unusual confusion or aggression?

8. Is there anything that makes it difficult to provide care right now?

9. How is the client feeling with the change in routine?

10. Are you needing in home respite to get groceries or errands?

11. What other agencies or resources may you need?

Time Completed