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LOG of WEEKLY SERVICES/SUPPORTS and DAILY PROGRESS NOTES for COMMUNITY CHOICES WAIVER PAS SINGLE EMPLOYEE PROVIDER AGENCY NAME: DIRECT SERVICE WORKER S NAME: RECIPIENT NAME: RECIPIENT DOB: Week Of:
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The log of weekly service supports is a record of services provided on a weekly basis.
All service providers are required to file the log of weekly service supports.
The log of weekly service supports should be filled out with details of services provided each week.
The purpose of the log of weekly service supports is to track and monitor services provided to individuals.
Information such as the type of service, duration, and date of service must be reported on the log of weekly service supports.
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