Shift Report
Date
/
Month
/
Day
Year
Employee's Name
First Name
Last Name
Shift Ends
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
05
10
15
20
25
30
35
40
45
50
55
Minutes
AM
PM
AM/PM Option
Shift Starts
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
05
10
15
20
25
30
35
40
45
50
55
Minutes
AM
PM
AM/PM Option
Census
New Submissions
Hospital Admits/Returns
New Med Orders
Emergency Doctor Calls
LOA
Discharges
Residents that are NPO
Clinic Appointments
Accidents
Special Notes on Residents
Special Notes/Reminders
Signature
Clear
Submit
SHIFT REPORT MUST BE COMPLETED EVERY SHIFT!!!!!!!
NO EXCEPTIONS!
Should be Empty: