EmailMe Form - Reminder : OVERNIGHT TASKS

Today's Date *

MM / DD / YYYY

My Name *

Non-Compliance *

I acknowledge that I am receiving this form (and filling it out) because I have recently not followed the agency's overnight policy

Overnight shift *

I understand that this refresher/ reminder is applicable for any overnight shift I work where the shift starts in the evening and ends in the morning

Questions *

I acknowledge that if I have any questions, I will call the office at 212-614-8057

Awake *

I acknowledge that I am required to be awake the entire time and I am being paid to be up and working during the entire shift

Hourly Clock-ins using WhatsApp *

I acknowledge that I am responsible to provide hourly updates on my client every hour on the hour

Alarm on my phone *

I acknowledge that the best way to assure I am able to do hourly updates is to put an alarm on my phone (on vibrate) to remind me

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I will actively check on my client *

Before reporting an update, I will actively check on my client (I will not assume my client is fine, I will check on him or her)

In the chat, please report whichever tasks are applicable *

If the client is awake or asleep

If I repositioned this client every 2 hours

Confirming that the client is clean and dry

I will report if the client is in any pain or distress

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Reminder Text *

If I don't update the chat every hour, I will receive a REMINDER TEXT within 15 minutes

Reminder Call *

If I don't respond to the reminder text within 15 minutes, I will receive a REMINDER CALL to my cell phone

Removal from Case/ Termination *

I acknowledge that if I cannot follow these steps that I will be REMOVED from the case and/or TERMINATED.

Signature *

Sign your name with mouse or with your finger

Any questions? Call us at 212-614-8057 or email us at *