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1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the individual’s name in the 'Individual Name' field, ensuring you include both first and last names.
3. Input the Local Case Number in the designated field to help identify the case associated with this log.
4. Fill in the date of service using the format mm/dd/yy. This is crucial for record-keeping.
5. Mark all areas where assistance was provided by checking or initialing next to each relevant activity under 'Activities of Daily Living'.
6. Record the time in and time out for each activity, ensuring accuracy for billing and reporting purposes.
7. In the comments section, note any special events or occurrences that took place during service delivery.
8. Finally, sign and date at the bottom of the form to validate your entries before submitting.

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