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Get Timesheet And Conveyance

Ider Signature: Client Signature: Print below signature Print below signature By signing above I acknowledge that I have verified the hours recorded on this By signing above I acknowledge that I agree with the amount of hours recorded on Provider Time Sheet. this Provider Time Sheet and authorize billing based on the terms of our contract with Mint. Day Date MM/DD/YY In Lunch (Mins) Reg Hours Out Prem Hours Holiday Call Back Week WeekNight end Call Call Patient Contact Hours Time.

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