Call log

Your Name*

Peer Number*

Date of Contact*

Time of Contact*

:

Length of Contact*

Topics covered

Surgery (what to expect, physical effects, making a decision, recovery from)
Emotional (feelings and emotions associated with diagnosis, treatment or recovery)
Practical (e.g. returning to work, finances, benefits, holiday insurance)
Relationships (family, friends, carers)
Diet (dietary issues or symptoms before or after surgery, PERT)
Chemotherapy (treatment, side effects)

Any other comments/summary

Any other issues/concerns

Has follow-up contact been arranged?*

Date/Day/Time of follow-up contact

Was this the final call?*

Phone

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