Caregiver Weekly Hours
Please do a new form PER CLIENT
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Email *
Name *
Client - ONE CLIENT PER FORM *
Monday: Date
MM
/
DD
/
YYYY
Monday: Time in
Time
:
Monday: Time out
Time
:
Tuesday: Date
MM
/
DD
/
YYYY
Tuesday: Time in
Time
:
Tuesday: Time out
Time
:
Wednesday: Date
MM
/
DD
/
YYYY
Wednesday: Time in
Time
:
Wednesday: Time out
Time
:
Thursday: Date
MM
/
DD
/
YYYY
Thursday: Time in
Time
:
Thursday: Time out
Time
:
Friday
MM
/
DD
/
YYYY
Friday: Time in
Time
:
Friday: Time out
Time
:
Saturday
MM
/
DD
/
YYYY
Saturday: Time in
Time
:
Saturday: Time out
Time
:
Sunday
MM
/
DD
/
YYYY
Sunday: Time in
Time
:
Sunday: Time out
Time
:
Hourly Rate *
Comments - If you have multiple times per day with the same client, create another form.
I understand and agree to Reliable Home Care Mich's pay-period schedule. Hours worked 1-15th are paid on 31st, hours worked 16-31st are paid on 15th. EX: 8/1, 8/2 paid on 8/31. 8/16, 8/17 paid on 9/15 *
I understand and agree to Reliable Home Care Mich's time sheet conditions: If I don't turn in my hours via this form, my hours are not considered collected until I do so. I agree and understand my check may be delayed due to the payroll processing times if I don't turn my hours in via this form & on time. *
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