Short Term Care Shift Report
Complete this report at the end of your short term care shift to document key details, activities, and any notable events.
Staff Full Name
*
First Name
Last Name
Date of Shift
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Shift Start Time
*
Hour Minutes
AM
PM
AM/PM Option
Shift End Time
*
Hour Minutes
AM
PM
AM/PM Option
Patient/Client Full Name
*
First Name
Last Name
List the care activities provided during this shift
*
Personal hygiene (bathing, grooming, etc.)
Meal preparation/feeding
Mobility assistance
Toileting assistance
Medication administration
Companionship/social interaction
Other
Were there any incidents or accidents during the shift?
*
No
Yes (please describe below)
If yes, please describe the incident or accident
Was medication administered during the shift?
*
Yes
No
Please provide details of medication given (name, dose, time)
Observations or concerns about the patient/client during this shift
Handover notes for next shift (important information to communicate)
Staff Signature
*
Submit Report
Submit Report
Should be Empty: