Sample Communications Log Worker Name: Supervisor Name: Expected RTW Date: Communications made by Person(s) Date of Method of Follow-up Communicated Details Contact Contact Required With Asked how they were, if they Example: needed anything. Responded Contact worker Injured worker Phone again between doing all right and don’t need November at home anything. Will follow-up in Nov 20-22nd 17, 2014 couple days.
Sample Communications Log Communications made by Worker Name: Supervisor Name: Expected RTW Date: Date of Contact Person(s) Communicated With Method of Contact Details Follow-up Required Example: November 17, 2014 Injured worker at home Phone Asked how they were, if they needed anything. Responded doing all right and don’t need anything. Will follow-up in couple days. Contact worker again between Nov 20-22nd
6%20Sample%20Communications%20Log.docx