Healthcare Medical Daily Timesheet

HEALTHCARE & MEDICAL DAILY TIMESHEET

WEEK ENDING:

CLIENT:

DOCTOR’S NAME:

FACILTY:

DOCTOR’S PHONE NO:

DEPT:

ASSIGNMENT CONTINUING:

Y

N

SHIFT START DATE

ORDINARY TIME

ON CALL

CALL BACK

Start

Finish

Break

Hours

Start

Finish

Hours

Start

Finish

Hours

Saturday

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Sunday

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Monday

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Tuesday

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Wednesday

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Thursday

…../…../…..

Friday

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TOTAL DAYS

TOTAL HOURS

TOTAL HOURS

TOTAL HOURS

Summary of Terms of Business relating to Temporary & Contracting staff

I certify that the number of hours set forth above is accurate and that services have been provided for the hours indicated and those services have been satisfactorily completed by the Contracting Personnel. By signing below, I agree to

arrange payment to Morgan Consulting Pty Ltd for the services provided according to the Terms of Business which I have received and accept as governing this transaction.

DOCTOR’S SIGNATURE:

SUPERVISOR’S NAME:

SUPERVISOR’S SIGNATURE:

SUPERVISOR’S TITLE:

PLEASE FAX TIMESHEET TO 03 8606 0301 BY 6 PM FRIDAY