HTML Preview Employee Detailed Sign In Sheet page number 1.
Date Time In Lunch 30/60 Time Out
PERFORMANCE EVALUATION (TO BE COMPLETED BY SUPERVISOR)
1 2 3 4 5 N/A
5 - Excellent
4 - Very Good
3 - Good
2 - Fair
1 - Poor
Comments:
Quality of Work:
Documentation:
Clinical Ability:
Professionalism / Ability:
Attendance / Punctuality:
Regular Time Overtime Double Time On Call Call Back Charge Hrs
Total Hours:
mediscan
staffing services
SIGN IN SHEET The deadline for sign in sheet is Monday, 12PM PST.
Client / Facility Department / ProfessionEmployee Name
Supervisor/Manager/Director SignatureMediscan Employee Signature*
Supervisor/Manager/Director Print Name
DateDate
Your signature certies that all of the above information is true and
accurate. You certify that no accident or injury was sustained while at
work during the time covered in this sign in sheet, except as reported
to Mediscan by submitting an accident report before/with this sign in
sheet. You certify that you have taken your 30-minutes lunch unless
otherwise noted and approved by supervisor.
All Sign In Sheets must be signed by a Supervisor.
The facility certies that: hours shown are correct, work was done
according to Quality standards, and facility agrees to the terms and
conditions of the Mediscan contractual agreement and will pay invoices
related to this sign in sheet in full.
Submit timesheets via email: TS@MEDISCAN.NET or via fax: 818-401-2126
www.mediscan.net