Nursing Statistics Report

Report your faith community nursing statistics here

Tips and Instructions

• Report your monthly statistics below
• Use any variation that is helpful to you
• Provide any information – it’s all helpful to us
• Fill-in as many fields as you can

Monthly Statistics Form

Month: January February March April May June July August September October November December

Year: 2009 2010 2011 2012 2013 2014 2015

Parish Nurse(s):
Congregation(s):
Parish Nurse Paid Hours:
Parish Nurse Volunteer Hours:

Individual Assessments/Contacts (not including group contacts or screenings)

Total Number:
Men:
Women:
Member:
Non-member:

Age:
0-12
13-17
18-65
66-80
Over 80

 

Group Contacts: Screenings

Type	# Screened	Age Range	# Abnormal

 

Education Programs/Support Groups/Healing Services (organized/coordinated by PN)

Topic	# Participants	Age Range	Comments

 

Comments/Other Notes or Programs: