Visitor Feedback CF Home Volunteer IV Visit Feedback This form is for active volunteers. Match Details Independent Visitor Name * Required Child/Young Person Initials * Required Date * Required Duration * Required Visit Details Brief description of activity / visit Any concerns or significant information to feedback (Non-safeguarding only, for Child Protection concerns follow the child protection policy guidance.) Were any health & safety issues or concerns raised? No Yes If Yes, please explain the issue(s). Outcome updates Did the child or young person display signs of meeting any of the following outcomes whilst on the visit? It might be that they spoke to you about something relevant to the questions below or how they acted during the visit. If yes, please give us a brief description of how in each box. Remember this may not happen at each visit and when that is the case please just put n/a at this visit. Improved social skills and being able to maintain friendships/relationships? Improved emotional well-being and mental health (increased confidence and self-esteem etc)? Practical life skills (becoming independent, decision making, budgeting etc)? Raised aspirations in life or education? Expenses Activity Cost (£ Amount) Mileage / Travel Claim You may have travelled to multiple locations during your visit, please include your total mileage in the box below and input the postcodes of where you started your journey and where you ended. If you used public transport you do not need to fill in this section of the form but click the public transport option. Public Transport Travel from (postcode) Travel to (postcode) Total Miles You must submit the receipts for the above expenses (not for mileage) to Elle Lawrence, at Changing Futures NE before expenses will be reimbursed to you. How would you like expenses repaid to you? * Bank Transfer (Direct into your account) Cash (You will need to come and collect from CFNE offices) Please complete the following if your bank details have changed: Bank Name: Account Name: Account Number (8 Digits): Sort Code (xx-xx-xx): Upload Document(s) [*] denotes a required field
