Grace Street Recovery Services

Weekly Time Sheet

Please Note: This will become effective June 23, 2017. We will no longer be accepting faxed time sheets. We are trying to streamline our processes.

Instructions:

This form is self explanatory. It contains 6 fields for each day worked. Form must be filled out completely or it will not be processed.

Time sheets must be emailed by EOB on Friday.

  • Date Field –  with pop up date picker
  • Time in/Time Out – Please separate with |
  • HRS Field – Please enter hours worked for each day.
  • Description – Enter description of work done
  • Program – Select the Facility where the services were performed
  • Units – Number of Billing units for each day

Total:

Total:

Total:

Employee/Contractor represents that the hours worked indicated above are true, complete, accurate and that no “off-the-clock” hours were worked. Employee/Contractor has had no work related injury or disease during this work week.and that all clinical documentation is completed and entered into the Grace Street Electronic Health Care System.

Enter Full Name.