Code Blue Nation - Phone Bank Reporting Form
Please let Code Blue know when you phone bank from home by yourself or if you host a phone bank for a group of people (in person or virtually). We want to report back to our Code Blue community and the the campaigns we support to let them know what we are doing collectively. This also helps motivate others to join the effort when they know they are not alone in their work.

If you want help hosting a phone bank, creating a virtual phone bank or have any questions please contact codebluewla@gmail.com.

THANK YOU FOR YOUR SUPPORT!

First Name
Your answer
Last Name
Your answer
Email
Your answer
Phone
Your answer
City
Your answer
State
Zip
Your answer
Date you made calls
MM
/
DD
/
YYYY
Are you hosting a phone bank or making calls yourself?
What campaign are you phone banking for? *
If you are HOSTING a phone bank please answer Questions (a), (b) and (c)
a) How many volunteers attended your phone bank
Your answer
b) Estimate how many calls you made as a group.
Your answer
c) Do you have any comments to share about how your phone bank went that you would want the Code Blue Community to know about, anything that worked really well, any surprises or interesting anecdotes from your calls or any suggestions of what could make a future phone bank better?
Your answer
If you are making calls yourself please answer Questions (d) and (f)
If you are at a phone bank please let the phone bank host report for everyone.
d) Estimate how many calls you made yourself.
Your answer
f) Do you have any comments to share about your experience that you would want the Code Blue Community to know about, anything that worked really well, any surprises or interesting anecdotes from your calls or any suggestions of what could make your future phone banking experience better?
Your answer
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