DISCLAIMER: By signing in the designated area(s) above I am confirming that the hours shown and the services provided were performed by the Direct Care Worker whose name appears on this time sheet. I hereby attest that all information listed on this form is accurate to the best of my knowledge and I understand that any falsification will subject me to criminal and or civil charges.
TIMESHEETS ARE DUE WITHIN 24 HOURS OF A MISSED EVV.