Date *
Name *
Shift worked *
Brief description of your shift ( Important tasks completed or achieved today) *
Have any urines or breath tests been done this shift? If yes please give details below
Has there been any issues with any clients that the team needs to be aware of? If yes, please give details below?
Have any clients brought up any important issues or case management actions that staff need to know about? If yes, please give details below
Has any client particularly impressed you with their attitude and participation in the program? If yes, please give details below
CM Team: Have you written a case note and sent it with your shift report? * YesNo
Was anyone completed, discharged or left the program on your shift? If yes, please give details and their reason for leaving below
Are any clients planning on leaving? If yes please give details below including their exit date if known (ensure CM team follow up, confirm and plan exit)
Do any clients have an upcoming appointment that the team need to know about? If yes, please provide details below
Are there any actions that need following up?
Are there any Mimaso issues that need to be fixed?
Have you added anything to the maintenance / WHS log? If yes, please give details below
(Optional) How are you doing? Is there anything we can do to support you better?
Is this your last shift for the week? If yes, please submit your time sheet * YesNo
Has all client medications been dispensed? If no, please explain.
