Charisma Healthcare Staffing – Employee Weekly Timesheet
Enter your weekly hours (Sun–Sat), totals, and attestations, then submit for facility approval before payroll is authorized.
Employee and Assignment Information
Employee Full Name
*
First Name
Middle Name
Last Name
Employee Email
*
example@example.com
Employee Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Placement ID
*
Client / Facility
*
Position / Role
*
Department / Unit
Week Start Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Week Ending Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Supervisor / Approver Full Name
*
First Name
Middle Name
Last Name
Supervisor Work Email
*
example@example.com
Submission Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Daily Time Entry (Sunday through Saturday)
Sunday Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Sunday Regular Hours
*
Sunday Overtime Hours
*
Sunday Holiday Hours
*
Sunday Other Hours
*
Sunday Notes
Monday Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Monday Regular Hours
*
Monday Overtime Hours
*
Monday Holiday Hours
*
Monday Other Hours
*
Monday Notes
Tuesday Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Tuesday Regular Hours
*
Tuesday Overtime Hours
*
Tuesday Holiday Hours
*
Tuesday Other Hours
*
Tuesday Notes
Wednesday Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Wednesday Regular Hours
*
Wednesday Overtime Hours
*
Wednesday Holiday Hours
*
Wednesday Other Hours
*
Wednesday Notes
Thursday Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Thursday Regular Hours
*
Thursday Overtime Hours
*
Thursday Holiday Hours
*
Thursday Other Hours
*
Thursday Notes
Friday Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Friday Regular Hours
*
Friday Overtime Hours
*
Friday Holiday Hours
*
Friday Other Hours
*
Friday Notes
Saturday Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Saturday Regular Hours
*
Saturday Overtime Hours
*
Saturday Holiday Hours
*
Saturday Other Hours
*
Saturday Notes
Weekly Totals, Attestation, and Certification
Total Regular Hours
Total OT Hours
Total Holiday Hours
Total Other Hours
Total Weekly Hours
Meal/Break Attestation
*
Yes
No
N/A
Assignment Notes
Employee Certification
*
I certify that the hours reported are complete and accurate, and I understand that falsification may result in corrective action.
Employee Electronic Signature
*
Submit Timesheet
Submit Timesheet
Should be Empty: