DATE START TIME MEAL PERIOD (IN MINUTES) END TIME CROSSES OVER MIDNIGHT? (YES OR NO) UNITS OF SERVICE (UOS) FIELD ENTRY TYPE INFORMATION Enter the date that the service took place. Date will also auto-populate the Job Task Section. DATE TEXT (REQUIRED FIELD) Enter the time that the actual service started, not the scheduled start time. START TIME TEXT (REQUIRED FIELD) Enter the meal period in minutes. For adults working over six (6) hours or minors working more than five (5) hours they must be provided MEAL PERIOD (IN MINUTES) TEXT a thirty (30) minute unpaid meal period. No service should take place during the meal period. Enter the time that the actual service ended, END TIME not the scheduled end time. TEXT (REQUIRED FIELD) Enter “YES” here if the shift crosses over CROSSES OVER MIDNIGHT? midnight, if it does not then leave this field TEXT (YES OR NO) blank. Field is calculated based on information entered in the report form. Providers may not edit this UNITS OF SERVICE (UOS) NON-EDITABLE field. TRANSPORTATION INVOICE SECTION Service End Date TRANSPORTATION Service Description INVOICE TOTAL $0.00
DATE START TIME MEAL PERIOD (IN MINUTES) END TIME CROSSES OVER MIDNIGHT? (YES OR NO) UNITS OF SERVICE (UOS) FIELD ENTRY TYPE INFORMATION DATE TEXT Enter the date that the service took place. Date will also auto-populate the Job Task Section. (REQUIRED FIELD) START TIME TEXT Enter the time that the actual service started, not the scheduled start time. (REQUIRED FIELD) MEAL PERIOD (IN MINUTES) TEXT Enter the meal period in minutes. For adults working over six (6) hours or minors working more than five (5) hours they must be provided a thirty (30) minute unpaid meal period. No service should take place during the meal period. END TIME TEXT Enter the time that the actual service ended, not the scheduled end time. (REQUIRED FIELD) CROSSES OVER MIDNIGHT? (YES OR NO) TEXT Enter “YES” here if the shift crosses over midnight, if it does not then leave this field blank. UNITS OF SERVICE (UOS) NON-EDITABLE Field is calculated based on information entered in the report form. Providers may not edit this field. TRANSPORTATION INVOICE SECTION Service End Date Service Description TRANSPORTATION INVOICE TOTAL $0.00
VR%20Forms%20Instructions%20Examples.docx