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
- 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
- Page 2: call log continued
- Page 3: do-not-contact requests log and monthly summary
- Agency instructions page, to remove before use
Add your logo and name
- Open the Word file and replace the Your Logo Here box with your logo.
- Replace Agency Name in the letterhead; the body says “the Agency,” so no other name edits are needed.
- Replace the Street Address, City, State ZIP line and the Phone, Email, Website line with your details.
- 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.
Buy Now – $4.41
Instant download via Payhip · Editable Word (.docx) · Secure checkout
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