Falcon Recruitment and Training Ltd.
Timesheet

Timesheet No:

FIRST NAME: CLIENT NAME:
SURNAME: UNIT:
GRADE: LOCATION:

Please write in BLOCK letters and use the 24-hour clock. The dates must be on the correct line to correspond with the days, and start and finish times included. Please ensure your break is deducted from the total hours and if you do not take a break please write N.B. Client must sign to confirm NB otherwise this will automatically be deducted. White Copy to be submitted to the office, Blue Copy to be left with the client.

DAY Date Start Break Finish Total Hours (excluding breaks) Ward / Unit Band Shift Reference Client Shift Appraisal Initial Induction Completed
MON    /    /                   1   2   3   4   5  
TUE    /    /                   1   2   3   4   5  
WED    /    /                   1   2   3   4   5  
THU    /    /                   1   2   3   4   5  
FRI    /    /                   1   2   3   4   5  
SAT    /    /                   1   2   3   4   5  
SUN    /    /                   1   2   3   4   5  

1 = Unsatisfactory | 2 = Poor | 3 = Satisfactory | 4 = Good | 5 = Excellent

Staff Declaration: I declare that the information I have given on this timesheet is correct and complete and that I have not claimed elsewhere for the hours / shift detailed on this timesheet. I understand that if I knowingly provide false information this may result in disciplinary action and I may be liable for prosecution and civil recovery proceedings. I consent to the disclosure of information from this timesheet to - and by - any Falcon Recruitment authorised body for the purpose of verification of this claim and the investigation, prevention, dectection and prosecution of fraud. I can confirm that induction and orientation training, and fire safety has been provided by the client.
NAME:  
DATE:  
POSITION:  
SIGNATURE:  
Client Authoriser: I am an authorised signatory for my ward / department / NHS body or other relevant organisation. I am signing to confirm that the job profile, title and band of the candidate and the hours / shift that I am authorising is accurate and I approve payment. I understand that if I knowingly provide false information this may result in disciplinary action and I may be liable to prosecution and civil recovery proceedings. I consent to the disclosure of information from this form to - and by - any Falcon Recruitment's authorised body for the purpose of verification of this claim and the investigation, prevention, detection and prosecution of fraud. I understand and agree to Falcon Recruitment's current terms of business. Note to client: Please can you ensure that you appraise the performance of the candidate using the client shift appraisal above.
NAME:  
DATE:  
POSITION:  
SIGNATURE: