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LTCO-00001 - CVA Activity Log
Added emails
0
Incorrect emails
0
Skipped emails
0
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Drag and drop csv file with emails
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Import
Region
*
Value is not selected
-- Select one --
North 1
North 2
Central 1
Central 2
Coastal
South 1
South 2
Email Address
*
Email
form field Email Address
is not in correct form
Name
*
Month
*
Value is not selected
-- Select one --
January
February
March
April
May
June
July
August
September
October
November
December
Facility
*
Number of Resident Council Meetings Attended
Survey Team Contact
Value is not selected
-- Select one --
Yes
No
Number of your hours in support: Travel/Paperwork
Form field Number of your hours in support: Travel/Paperwork has
Invalid numeric value.
Dates
Add a date
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Total Number of Residents
Total Number of Hours on Site
Other significant events (such as conducting Residents’ Rights Bingo) or comments (such as meeting with DOH survey team) or pending activities.
Email Address:
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