Skip to content
Notes/Jordan Abelard/Jul 1, 2026, 1:00 PM
JA

Note · Jordan Abelard

completedEVV pendingclient signed·Jul 1, 2026, 1:00 PM · 120 min
Service record
Jordan Abelard · Employment exploration
PDF
Jul 1, 20261:00 PM – 3:00 PM · 120 min · 8 unitsMaria Peterscompletedacceptedclient signed
Clock in
Jul 1, 2026, 1:00 PM
44.9841, -93.2557
Clock out
Jul 1, 2026, 3:00 PM
44.9783, -93.2627
Medications on 2026-07-01
  • 09:15Omeprazole20 mg
Level of interaction
Skills worked on
Daily activitiesPick each activity you did with Jordan
  • Assisted Jordan with setting boundaries and navigating social interactions
  • Assisted Jordan with setting up reminders and systems for appointments and scheduled events
  • Assisted Jordan with organizing personal belongings and daily tasks
Support plan goals
Improve social skills
Did Jordan participate in a community outing?
Did Jordan start a conversation with a peer or staff member today?
Cook two meals a week
Did Jordan help plan or cook a meal today?
Progress review
signed by staff
Signatures
  • Caregiversigned Jul 1, 2026, 3:02 PM
  • Clientsigned with code Jul 1, 2026, 3:01 PM
  • Reviewaccepted on submission
Authorization SA-2026-00103PMI 12345678NPI 1234567893POS 12
Accepted Jul 1, 2026, 3:02 PM

Aggregator record

Exactly what the EVV aggregator and the 837P claim line receive

Provider tax ID
41-0000000
PMI #
12345678
Service code
T2019 U2
Units
8 × 15 min
Place of service
12 · Home
Rendering staff
Maria Peters · NPI 1234567893
Authorization
SA-2026-00103
Clock in
Jul 1, 2026, 1:00 PM
Clock out
Jul 1, 2026, 3:00 PM
GPS at clock in
44.98407, -93.25575 · ±8 m
GPS at clock out
44.97826, -93.26273 · ±10 m
Manual entry
No
Client signature
Signed with code Jul 1, 2026, 3:01 PM

Tasks

2 of 2 completed

  • Personal care / ADLs
  • Skill building per support plan

Shift note

Employment exploration. Visited Goodwill and spoke with the floor lead about stocking and donation intake. Jordan asked two questions about hours. Afterwards listed what was liked (moving, sorting) and disliked (noise at the register).

Edit history

Kept with the note and exported as EVV evidence

No edits since creation.

Edit this note

A reason is required. The change is kept as history and the note is marked manually adjusted for EVV.