A special thanks to JetBlue for their generous support of ACCESS

Volunteer Grief Mentor Log sheet | ACCESS

Volunteer Grief Mentor Log sheet

For ACCESS Volunteer Grief Mentors only:
Please fill out this form after each contact with the client you are mentoring or after the 3rd unsuccessful attempt to make contact.

Click here to download the PDF version of the Log Sheet.

Terms of Volunteer Grief Mentoring

Mentoring Date:

Your Name (required):


Your Email (required):

Client Information:

Client/Caller's Name:


Best Time(s) to Call:

Client Email:

Prefers to be contacted by:

Email communication is acceptable, but communicating by telephone is a more effective form of mentoring. If possible, try to set up a phone appointment with the person you are mentoring.

Name(s) of loved One(s):

Relationship / Age(s):

Air Carrier / Flight Number:

Call / Email Log:

Date / Time:

Attempted Contact by:
 Phone Email


Date / Time:

Attempted Contact by:
 Phone Email



Attempted Contact by:
 Phone Email


Summary of Client / Caller's Response

Thoughts / Feelings:

What was the focus of the call?

His/Her available support systems:

Your Assessment:
 Doing as well as can be expected
 Concerned about his/her mental state (if so, explain below)

Additional Comments or Concerns:

Your Next Step:
 Follow up call Follow up email
To be made on:

Information / Referral Requested (explain):

Thank you for being a Volunteer Grief Mentor.
You are the heart of ACCESS!

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Surviving Sudden Loss: Stories from those who have lived it

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Families We Have Helped:

Below are some of the air disasters that we have responded to:
Private Plane - 9/26/12
Rockingham County, VA
Private Plane - 2/27/11
Abu Dhabi
Private Plane - 12/22/10
Barrington, NY
Private Plane - 7/17/10
South Portland, ME
Air India Express 812 - 5/22/10
Mangalore, India
Afriqiyah Airways 8U771- 5/12/10
Tripoli, Libya
Ethiopian Airlines 409 - 1/25/10
Off of Na'ameh, Lebanon
Air France Flight 447 - 6/1/09
Atlantic Ocean
Turkish Airlines Flight 1951 - 2/25/09
Amsterdam Airport Schiphol
Continental Flight 3407 - 2/12/09
Clarence Center, NY
US Airways Flight 1549 - 1/15/09
Hudson River, NY
Aeroflot Flight 821 - 9/14/08
Perm, Russia
Spanair JK 5022 - 8/20/08
Madrid, Spain
TAM Airways JJ 3054 - 7/17/07
São Paulo, Brazil
Comair Flight 5191 - 8/27/06
Lexington, KY
Airbus A320-211 - 5/3/06
Off Sochi, Russia
Bellview Airlines - 10/23/05
West Caribbean Airways 708 - 8/16/05
Machiques, Venezuela
Air France Flight 358 - 8/2/05
Ontario, Canada
Kam Air Flight 904 - 2/3/05
Pamir Mountains, Afghanistan
Corporate Airlines 5966 - 10/19/04
Pettis Township, MO
Kish Airlines Flight 1770 - 2/10/04
United Arab Emirates
Georgian Express Flight 126 - 1/17/04
Ontario, Canada
Flash Airlines 604 - 1/3/04

Red Sea

Turkish Airlines 634 - 1/8/03

Diyarbakır Airport, Turkey

US Airways Express/Air Midwest Flight 5481 - 1/8/03

Charlotte, NC

American Flight 587 - 11/12/01

Queens, NY

The events of September 11, 2001

Private Plane - 12/3/00
Milltown, WI
Singapore Airlines 006 - 10/31/00

Chiang Kai-shek Internat'l Airport

Gulf Air Bus A320 - 8/23/00

Persian Gulf, Bahrain

Air France Concorde 4590 - 7/25/00

Gonesse, France

Alaska Airlines 261 - 1/31/00

Pacific Ocean

Egypt Air 990 - 10/31/99

Atlantic Ocean

American Airlines 1420 - 6/1/99

Little Rock, AR

Swissair 111 - 9/2/98

Atlantic Ocean

Private Plane - 8/4/98
Phillips, WI
TWA 800 - 7/17/96

US Air 427 9/8/94

Allegheny County, PA

Long Island, NY

Pan Am 103 - 12/21/88

Lockerbie, Scotland

TWA/United Airlines - Mid-Air Collision- 12/16/1960
Brooklyn & Staten Island, NY
and hundreds of other private, commercial and military air disasters

See Full List