Date
Day/Night DayNight
Counsellor name
Short description of shift
Has any urines been done for the shift YesNo
If yes, description
Has any one been breath tested for the shift YesNo
Has any client had to be spoken to for doing the wrong thing YesNo
Has any client brought up any important issues or case management actions that staff need to know about YesNo
Has any client particularly impressed you with their attitude and participation in the program YesNo
Have you written a Case Note and sent with your shift report YesNo
Have you added anything on the maintenance / WHS log? YesNo
Was anyone completed, discharged or left the program on this shift? YesNo
If yes, description (their reason for leaving)
Are any clients planning to leave? Have they given an exit date? (Case Management team to follow up, confirm & plan exit)
Do any clients have an upcoming appointment that the team need to know about?
Are there any actions that need following up?
Any Mimaso issues that need fixed?
Is this your last shift for the week? ( If yes you need to fill in time sheet ) YesNo
