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Form – Missed Clock In/Out Times
Shaun
2020-05-20T11:24:11-04:00
Please enter your missed time information below.
Missed or Incorrect Punches
Caregiver Name
*
Phone Number Used:
*
Enter all zeros if you did not make any calls.
Date of Missed or Incorrect Punch
*
Missed or Corrected "Time In":
12
1
2
3
4
5
6
7
8
9
10
11
:
00
05
10
15
20
25
30
35
40
45
50
55
AM
PM
Missed or Corrected "Time Out":
12
1
2
3
4
5
6
7
8
9
10
11
:
00
05
10
15
20
25
30
35
40
45
50
55
AM
PM
Reason for Missed or Incorrect Punch
*
Forgot
Lost or Broken OTP
System did not accept call or call incomplete
Phone problem or poor cell coverage
Client emergency
Clock-in system outage
In community with client
Need more training
By signing below, I certify the above information is correct and understand any missed punch may be counted as a mistake for the month. I understand that repeated missed punches may lead to disciplinary action, including termination.
*
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