• Consent for Early Clock Out

    EC1_v1.0.0_2025-11-12

  • Part 1: Staff Member Information

  • Pass the device to the client to sign the form now...

    Note: If you leave the clients premisis early and do not have written consent you may not get paid for full length of the shift.

     

  • Part 2: Client Consent

    I {typeA5} am giving consent for my service worker {staffName} to leave early for the following reason(s):

    {reasonsFor}

    NOTE: You are not required to sign if you do not agree to the above statement.

    If uncomfortable in any way, please contact the office on 8124 8554 to let us know and we can assist you further.

  • Time and Date of Consent
     - -
    2 digit day, 2 digit month, 4 digit year
  • Should be Empty: