FOLLOWING ARE FORMS THAT CAN
BE PRINTED
ATTENTION PROVIDERS
- Please read the following:
New requirements for time sheets as of January 20th 2010 -
Please read the information below!
All days worked between the 1st and the 15th of the month must be at the office of ACCENT no later than the
15th. All days worked between the 16th and 31st must be on another time sheet and be at ACCENT no later than the last
day of that same month. Time sheets can be delivered, faxed or emailed on or before the 15th or
last day of the month. The original must also be mailed on that date as well. If time sheets are not received
by or before the 15th and last day of the month then paychecks may not be issued until the following pay period. Both the parent and provider
must sign the bottom of the time sheet and the parent must initial after every day that is worked. Record times
based on the quarter hour and round each days total to the nearest quarter hour. Time sheets must be submitted
free from errors and corrections. Please note that respite must be no more than 12.75 hours per
calandar day. The State will not pay for more than 12.75 hours.
Paychecks should be received within 10 days of the end of the time period which is either the 10th or
the 25th of each month.
*Employee Time Sheet download
This time sheet automatically calculates hours worked. Just download the file,
enter the dates and times worked along with the other information needed and then print out the completed form.
Please indicate AM or PM on the "time in" and "time out." The totals will automatically
be calculated.
All requirements
for the Electronic Time Sheet are the same as for the regular Employee Time Sheet. Please refer to the information on
the above Employee Time Sheets for directions on properly submitting time sheets.
*Electronic Time Sheet download
Anytime a provider administer's over-the-counter medicine or
prescription medicine the date and dosage must be filled out
on
this form. This form must be returned to ACCENT at
the end of
every month.
*Medicine Log download
If
a client is injured in any way for any reason while the provider is
working with the client, or, if the client had severe
behaviors that warranted
emergency measures, then an incident form must be filled out and sent
to both ACCENT and the client's
support coordinator within 24 hours.
*Incident Report download
*Parent / Client Forms download
Forms for parents or guardians of clients starting services with ACCENT. Forms include: Welcome Letter,
Guardian Consent, Client Information Page, Transportation Waiver and Pre-service Provider Orientation.
*GRIEVANCE, EVALUATION, EXPECTATION, COMMENT Forms Download
