COVID-19 Outbound Welfare Calls to NHS Shielded Patient List Form and Workflow - Library

Item Description

This form is used to contact citizens whom are vulnerable under the NHS shielded patient list. 

The purpose of this form is to identify the needs of these citizens in order to match up with volunteers whom can help support them.

The form will ask

  • if essential supplies are needed.
  • will their existing supplies last for at least a week.
  • any specific dietary requirements.
  • if they are managing their personal care/hygiene needs.

This form can be imported into Continuum XFP and edited and amended to meet your needs.

View Form Demo

Direct Download Link
Minimum requirements
XFP #109
Integrated Systems
CXM (optional)
Target Audience
Lead Customer
Methods (created by Central Bedfordshire Council)
User Tested
This artifact has been user tested.