VOLUNTEER REPORT FORM

• Click here for the electronic Volunteer Report Form. You can print and complete this form, or fill it out online and e-mail it to LTCO.

• Click here for the electronic form for Resident Council and Family Council visits. You can print and complete this form, or fill it out online and e-mail it to LTCO.

• Click here for the Volunteer Follow-up Report on Complex Complaints

• Click here for the electronic Intake Form. You can complete this form online line and email it to LTCO.

• Click here for the hard-copy Intake Form. You can print and complete this form and fax or mail it to LTCO.

Long Term Care Ombudsman
2800 Euclid Avenue, Suite 200, Cleveland, Ohio 44115
800-365-3112 216-696-2719 info@ltco.org www.ltco.org
Serving Cuyahoga, Geauga, Lake, Lorain & Medina Counties in northeast Ohio