Practice Paperwork

Client's Name: John Doe

CIN: AB12345X

TABS: 12345

Schedule:

Tuesday - 3:00pm - 8:00pm  

Thursday - 5:30pm - 8:00pm

Friday - 12:00pm - 1:30pm

Saturday - 11:00am - 3:00pm

Monday - Vacation Time (4 Hours)

Wednesday - 11:00am - 4:00pm (3 hours CH + 2 hours Respite)

Receipts:

$50.00 - Spoon & Whisk Cooking Class 3/4/2019

$7.99 - Subway (Lunch) 3/6/2019

Mileage:

3/2/19 - Home (123 Main Street, Queensbury, NY 12804)

             Spoon & Whisk (123 Clifton Park Ave, Clifton Park 12065)

             Total Mileage: 29

3/4/19 - Home (123 Main Street, Queensbury, NY 12804)

             YMCA (3 YMCA Lane, Saratoga, NY 12866)

             Total Mileage: 12

3/5/19 - Home (123 Main Street, Queensbury, NY 12804)

             Firehouse (78 Firehouse BLVD, South Glens Falls, NY 12805)

             Total Mileage: 5

3/6/19 - Home (123 Main Street, Queensbury, NY 12804)

             YMCA (3 YMCA Lane, Saratoga, NY 12866)

             Bowling Alley (16 Bowling Alley Way, South Glens Falls, 12866)

             Total Mileage: 26

Support-Link, Inc.

383 Bay Road

Queensbury, New York 12803

Phone Number: 518-798-2972

Fax Number: 518-798-2975

Support-Link, Inc. is a not-for-profit (501c-3) agency, formed in 2007.  We provide high quality, comprehensive services to individuals with developmental disabilities, traumatic brain injuries, children and senior citizens in Albany, Essex,  Clinton,  Franklin, Fulton, Hamilton, Montgomery, Saratoga, Warren, Washington, and Rensselaer Counties. 

© 2018 by Support-Link, Inc.

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