EVV & Scheduling

Two editable Word templates for a USA non-medical home care agency, in one instant download. Record missed and late visits, EVV exceptions and manual time corrections with two matching forms for your scheduling and payroll staff.

Every file is an editable Microsoft Word (.docx) document. This is a Word-only download: no PDF, Excel, or Canva files are included. You can also open the files in Google Docs or LibreOffice; some layout may shift slightly.

What’s included (2 templates, 3 Word files in one ZIP)

1. Missed, Late Visit and EVV Exception Log (5 pages, Word)
2. Manual Visit Verification and Time Correction Form (3 pages, Word)

Plus an Agency Instructions guide for the whole set. Remove it before use.

Who it’s for

• Schedulers and office staff handling missed or late visits
• Agencies using electronic visit verification (EVV)
• Payroll and billing staff fixing visit times
• Owners keeping an exception record

How it works

1. Purchase and instantly download one ZIP file with all the documents.
2. Open each file in Microsoft Word.
3. Use Replace All (Ctrl+H) to change [Agency Name] and [State] to your own details.
4. Fill in the blank lines with your own policies, contacts and choices, then save, print or share as needed.

Please note

• This is a digital download. No physical item will be shipped.
• These are customizable templates, not legal advice, and are not a license to operate or state-approved. They do not guarantee that your agency meets any law, licensing survey or standard.
• State rules vary. Check every state-specific item against your state requirements and have a qualified professional review the templates before use.
• Some lines cross-reference policy numbers from a companion Policy & Procedure Manual (sold separately); edit them to match your own policies.