PAPERWORK DUE	MONTH/YEAR
STAFF NAME	DATE DUE
Enter staff name, month/year, and date paperwork is due. Enter client name and mark the service provided and paperwork being submitted with an X. Mark each service for each client on separate rows. Enter the total hours/days you were assigned for the month, the actual hours/days you worked this period, and the total hours/days you have worked to date.
CLIENT NAME

SERVICE	PAPER
WORK	DAYS/HOURS	REVIEW – FOR OFFICE USE ONLY
SLC	PS-
Day	PS-
Qtr	LSD1	Service Log	Hrs/Days Assigned for Month (Total)	Hrs/Days Worked This Week	Total Hrs/Days Worked to Date	OK	REDO	Date Reviewed	Date Returned for REDO	Date REDO returned
REVIEWER COMMENTS	Reviewer: Write clearly and state specifically what correction needs to be made.