ATTENTION: Drop off at office OR fax to (844) 766-0107 OR upload at austin-983-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your address in the designated field. This ensures accurate identification and processing of your submission.
3. Fill in your Employee Number, which consists of '983' followed by the last four digits of your Social Security Number.
4. Provide your City, State, and Zip Code for location verification.
5. Indicate the week ending date (Sunday) to specify the reporting period for your work log.
6. Check all applicable boxes under WORK LOG for services provided during the week, including HOMEMAKING/COMPANIONSHIP CARE and PERSONAL CARE SERVICES.
7. Complete the FREQUENCY OF TASKS section by checking relevant tasks performed throughout the week.
8. Log daily start and finish times for each shift in the TIME LOG section, ensuring accuracy for payroll processing.
9. Have the client sign where indicated to verify services rendered and ensure compliance with company policies.

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