Sample
E mployer
C ontact
L og
Date
o f
C ontact:
_ ______________________________
Name
o f
C ontact:
_ ______________________________
h as
h iring
r esponsibility
Purpose
o f
t he
C ontacts:
T o
s ecure
a n
a ppointment
T o
l earn
a bout
t he
e mployer
T alk
a bout
a
c andidate
O ngoing
r elationship
O ther:
_ _______________________________________________
Information
l earned
a bout
t he
e mployer’s
b usiness
a nd
h iring
p references
( or
o ther
n otes):
Next
s tep
( include
d ate):
E mployment
s pecialist
s ignature:
_ _________________________________________________
Dartmouth
P sychiatric
R esearch
C enter
Revised
M arch
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