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VisibleCare.Health™ Visit Confirmation

Please complete this form at the end of each visit. This form confirms attendance and basic observations (No medical information required)

Client Name

Visit Date

Time Visit Started

Mood Observed

Mood Observed
A
B
C

Medication Reminder given (Non-Medical)

Medication Reminder given (Non-Medical)
A
B
C

Meals Observed During Visit

Meals Observed During Visit
A
B
C

Home Safety Check

Home Safety Check
A
B

Notes (1 sentence max)

Visit Proof Photo

Please upload a quick photo of your badge/ID placed on a table or flat surface inside the client's home. No faces, no clients, no medical images. Timestamp only

Time Visit Ended