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Daily Reporting Form
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Email
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Your email
Today's date
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MM
/
DD
/
YYYY
Select the county you worked in today
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Davie
Davidson
Randolph
Other:
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Select your name
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Choose
Holliane Sherrod
Jordan Scott
Da'Quawn Thompson
D'Andre Taylor
Dalynn Cuthbertson
Robert Hankins
Benjamin Davis
Christopher Clodfelter
Kayrone Hargrove
Kyle'Q Williams
Ileq Jones
Aisha Deskins
Monique Turner
Number of unduplicated persons served in-person who have COVID-19 related needs today.
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Your answer
Number of Telehealth encounters(including social media) with persons who have COVID-19 related needs today.
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Your answer
How many of your Telehealth encounters resulted in a conversation(video meeting, replies to posts, DMs, etc)?
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Your answer
How many individuals did you call today regarding medical needs (vaccinations/testing)?
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Your answer
How many individuals did you call to follow up on getting their 2nd vaccine shots?
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Your answer
How many individuals did you call about reasons not related to medical needs?
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Your answer
How many individuals did you register to receive a COVID-19 vaccine using CVMS?
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Your answer
How many individuals did you schedule to receive a COVID-19 vaccine using CVMS?
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Your answer
Did you work at any events today? What was it?
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Your answer
Summary of your day
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Your answer
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