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Aged Care eConnect

Appendix H - Virtual visiting booking information sheet

A resource kit for residential aged care facilities

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Appendix H
Sample Only

Virtual Visiting

Keeping Connected
Booking Information Sheet

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This document is part of the Virtual Visiting Resource Kit for Residential Aged Care Facilities developed by Western District Health Service Victoria as part of the Virtual Visiting Project funded by the Australian Government Department of Health and Ageing.

Disclaimer
This publication and all its contents are provided to assist aged care services to implement virtual visiting.

Any policies and practices dealing with these areas should be developed in the context of relevant legislation, codes of practice and other professional standards, policies and guidelines relevant to the practice setting, together with appropriate advice on legal issues.

The Australian Government and the authors expressly disclaim all and any liability to any person, whether a purchaser of this publication or not, in respect of anything and of the consequences of anything done or omitted to be done by any person in reliance, whether in whole or in part, upon the whole or any part of the contents of this publication.

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Sample Only
Note for aged care facility
Insert the name of your organisation

Virtual Visiting
Booking Information Sheet

Facilitator
Volunteer

Resident
Resident Name

Visit
Date
Time

Family Member
Family member
Phone contact number

Internet video conference provider details
Name of video conference provider

Name of family as registered with video conference provider
Family virtual visiting name

Location and wall point (for polycom video calls only)
Location (room)
Wall point number

Further instructions :

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Copyright Notice

©Commonwealth of Australia as represented by the Department of Health and Ageing 2010

Disclaimer

This document and its contents are to be used as a general resource to assist aged care facilities to run a virtual visiting program. Any aged care facility using information from this document should first obtain its own independent professional advice from a qualified person or expert to determine the suitability and appropriateness of running a virtual visiting program in its facility before relying on any information contained in this document.

Acknowledgment

This document has been developed by the Western District Health Service as part of the Virtual Visiting Project funded by the Commonwealth Department of Health and Ageing.

Creative Commons Licence

This work is copyright and licensed under a Creative Commons Attribution 3.0 Australia licence, a copy of which is available at Creative Common website.

By exercising any rights granted to you under the above licence, you will have accepted, and have agreed to be legally bound by, the terms and conditions contained in the Creative Commons Attribution 3.0 Australia (By Attribution) licence.

Notice Requirements

When exercising any rights granted to you under the above Creative Commons Attribution 3.0 Australia (By Attribution) licence, you must keep intact the above copyright and disclaimer notices.

Attribution Requirements

This document must be attributed as ‘Virtual Visiting – Keeping Connected: A Resource Kit for Residential Aged Care Facilities’.

You must attribute the Western District Health Service by using the above acknowledgment.

Further Inquiries

Inquiries regarding the Creative Commons Attribution 3.0 Australia licence and requests for any other use of this document are to be sent via the post to the Communications Branch, Department of Health and Ageing, GPO Box 9848, Canberra ACT 2601, or via e-mail the Department of Health and Ageing.
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