Bereavement Family Follow-Up Log

Logs post-death contacts with the family, including condolence outreach, support needs, and follow-up actions.

Death Record and Case Context

• Patient or case identifier
  Use the internal case ID or other minimum-necessary identifier. Do not enter SSN or other unnecessary PII.
• Date of death
• Program or service
• Primary family contact relationship

Consent and Contact Preferences

• Permission to contact family for bereavement follow-up confirmed
• Preferred contact method
• Preferred contact window
  Example: weekday mornings, evenings after 6 PM, or no preference.
• Do not contact requested
  Select if the family requested no bereavement follow-up contact.

Follow-Up Contact Log

• Contact date
• Contact time
• Contact method
• Contact outcome
• Condolence message delivered
  Check if condolences were shared during this contact.
• Contact notes
  Document only relevant follow-up details. Avoid unnecessary personal or clinical information.

Bereavement Needs and Support

• Support needs identified
• Urgent concern present
• Urgent concern details
  Describe the concern and any immediate escalation taken. Keep details limited to what is necessary.
• Resources provided

Follow-Up Plan and Audit Trail

• Next follow-up date
• Assigned to
  Enter the staff member or role responsible for the next action.
• Follow-up status
• Internal notes
  For internal coordination only. Do not include unnecessary PII.