COVID-19

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* 1. Employee First Name

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* 2. Employee Last Name

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* 3. Employee ID Number

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* 4. Hourly or Exempt

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* 5. Business Unit

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* 6. Department Name

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* 7. COVID-19 Activity (e.g., EOC, report, policy, direct patient care, billing, etc.)

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* 8. Date

Date

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* 9. Start Time

Time

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* 10. End Time

Time

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* 11. Total Hours

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* 12. Signature

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