5th Annual Pickleball Palooza Saturday, May 13, 2023
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Volunteer Activity Report

  • If you have any questions regarding this form or your responsibilities to a patient please call 410-1010.

    ***For direct patient contacts reports must be received within two (2) days from date of activity.

    If you have an immediate patient concern, please call Hoffmann Hospice at 661-410-1010 and ask to speak with the triage nurse. Please notify the Volunteer Coordinator after notifying triage.

  • (You will receive a confirmation email once your report has been successfully submitted)

  • (Max 6 numbers)

  • Please describe what you did during your visit.

  • Activity Time and Mileage

  • Please enter in 15 minute increments. Examples: If you get there at 2:25pm, please use 2:30pm. If you get there at 2:08pm, please us 2:15pm.

    :
  • :
Dignity Health Mercy & Memorial Hospitals
CHAPCA - California Hospice and Palliative Care Association
Department of Health & Human Services - Medicare Certified
National Hospice and Palliative Care Organization
CHAP - Community Health Accreditation Program
The American Academy of Bereavement
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  • 4325 Buena Vista Rd. Bldg. A Bakersfield, CA 93311
  • (661) 410-1010
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