Get Tx Form 3054 2009-2025

Filling out the TX Form 3054 online is essential for documenting the service delivery related to primary home care. This guide will provide step-by-step instructions to help you navigate each component of the form effectively.

Follow the steps to successfully complete the TX Form 3054 online.

1. Press the ‘Get Form’ button to obtain the TX Form 3054 and open it in your chosen online editor.
2. Enter the 'Employee Name' and 'Employee Mailing Address' in the designated fields. If there are multiple employees, ensure to list all relevant employee names.
3. In the 'Client Name' section, input the name of the individual receiving care. Fill in the 'Client No.' and 'County' to specify the client’s information.
4. In the 'Task(s) Assigned' section, check each applicable task that has been provided to the employee, such as bathing, meal preparation, or cleaning. If there are specific tasks not listed, utilize the 'Other' field to specify.
5. Record the 'Scheduled or Authorized Hours' for each day of the week, indicating the time 'In' and 'Out' for services rendered from Sunday through Saturday. Compute and enter the 'Total' for each day.
6. In the 'Record of Time' section, log the actual time worked daily, specifying the 'Time In' and 'Time Out' for each corresponding day of the month. Calculate the 'Total Daily Time' and summarize in the 'Monthly Total of Hours' section.
7. Once all information is entered, review the form for any missing or incorrect entries. Ensure all tasks are accurately listed and times are correctly recorded.
8. Finally, obtain the required signatures in the 'Signature–Employee' and 'Signature–Timekeeper' fields, ensuring the date indicated is not before the last day worked. Save your changes, download, print, or share the completed form as needed.

Complete your TX Form 3054 online today to ensure timely and accurate documentation of care services.