Time Log
Staff Member*
Staff Member 2
*If two support are Required
Date
Day Month Year
Date of Support
Client Name*
First Name Last Name
Assistance with Daily Living
Assistance with Social and Community Participation
Assistance with Self Care Activities
Food Preparation
Specialised Items
Travel Time - 30 Mins
Yes
Notes on the Day/Session
Progress Notes, or notes from the day
How did today's session meet the {name}'s Goals?
Is {name} willing to sign today's session?*
Yes No, please provide more information
Reason for Not Signing
Please Provide Further Detail
{Name}'s Signature
Clear
{staffMember}'s Signature 1*
Clear
{staffMember26}'s Signature 2
Clear
Was there an Incident Today?
Yes - Please complete incident report form AFTER Submitting this form
Should be Empty:

Time Log