* = Required Information
Day
Date
Time In
Time Out
Off Time
Total Hours
Client Authorized Signatures
Unit
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Day
Date
On Call Time In
Call Time In
Back Time Out
Call Time In
On Call Time Out
Authorized Signatures
Unit
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Facility
Total Hours
Regular Hours
Overtime Hours
Employee Signatures
*
On Call Hours
Call Back Hours
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