This record sheet is designed to assist Welfare Officers with record keeping for DVA BEST grant applications and acquittals
For each date of contact for each person enter the following information. Instructions next page
Quarter:
Date / Name & DVA No. / Client Type / Type of Contact / Referral made / Time Taken / Purpose / Travel information
WW / WW -er / Vet / ADF Current / Other / Phone Enquiry / Interview / Metro home visit / Country home visit / Mins / Main Topic / Km Rtn / $ Cost calc @ .293 c per km
Totals
Welfare Officer Record - Instructions
This is designed for TIP Trained Welfare Officers to assist with records for BEST applications and acquittal.
Date: / Enter date of contact
Name & DVA No.: / Enter Client Name and DVA number (if known)
Client Type: / Put a "1" in column that best describes that client
Type of Contact: / Put a "1" in column that best describes type of contact (may be more than one) described below
- Phone Enquiry / Initial enquiry or phone interview
- Interview / Face to face interview
- Metro Home Visit / Metro visits or local visits in town where Welfare Officer lives - includes hospital visits and funerals
- Country home visit / Where Welfare Officer travel to country area for welfare work - includes hospital visits & funerals
Referral made: / Put a "1" in column if WO referred client to any other agency for assistance
Time taken: / Minutes spent with client (includes time travelling to and from but NOT office work)
Purpose: / Two or three words describing main reason for visit
Travel information / The travel information + name and DVA number is in lieu of a travel log book
Cost Calculation – Multiply the kilometres travelled by cost per kilometre to calculate cost per trip.
NB * Costs per kilometre change every 1st July - please check with DVA BEST officer what current rates are
Quarter / Jan - Mar 01 Welfare Officer Statistical Record Example
Date / Name & DVA No. / Client Type / Type of Contact / Referral made / Time Taken / Purpose / Travel Information
WW / WW-er / Vet / ADF Current Serving / Other / Phone Enquiry / Interview / Metro home visit / Country home visit / Mins / Main Topic / Km Return / Cost calc @ .286 c per km *
11/02/2001 / F Example WSM 3234 / 1 / 1 / 1 / 70 / health problem / 24 / $6.86
12/02/2001 / J Bloggs WX4455 / 1 / 1 / 1 / 40 / help w shopping / $0.00
27/02/2001 / J Bloggs WX4455 / 1 / 1 / 60 / social contact / 30 / $8.58
28/02/2001 / A Private / 1 / 1 / 1 / 40 / accident / $0.00
7/03/2001 / W Friend / 1 / 1 / 1 / 1 / 120 / Funeral / 42 / $12.01
Example Totals / 1 / 1 / 2 / 1 / 0 / 2 / 2 / 1 / 2 / 3 / 330 / 0 / 96 / $27.46
An Excel version of this document can be download from website: look under WA or contact WA TIP Coordinator on 08 9366 8462.