When the care of one person is shared, hours are easy to lose track of. A daughter covers Tuesday afternoons, a neighbor sits in on Thursdays, a helper the family arranged comes three mornings a week. By Friday nobody is sure who was there, for how long, or whether the shopping got done. A timesheet is a written record of the week that both people can see and initial, day by day. This one is in large print, so it can be read and filled in by the person cared for too.
This timesheet is a blank record-keeping form. It is not an official timesheet for any state, Medicaid, insurance or agency program. If the care is through a program, use that program's own form and check what it requires.
What's in the free file
- One week on one page, Monday to Sunday, with a row for each day: the date, time in, time out, hours, and the initials of the caregiver and of the family.
- A box for the total hours, under the week. The file does no sums: add up the week yourself.
- Tasks done, as tick boxes: meals, washing, dressing, housework, laundry, errands, appointments, company, and other with a line to say what, with a box for each day.
- Two signature lines, for the caregiver and the family, each with a date. They are for signing by hand on the printed page.
- Lines at the top for the caregiver's name, the person cared for and the week.
- A second page on how to fill it in, with the note that it is not an official program form.
- Large print. The title is 26 point, the labels 16 to 18 point and the table headings 14 to 16 point.
- Fill-in fields. Type into every line and tick the boxes before you print, in the free Adobe Acrobat Reader, or print it blank and write by hand.
- Sizes: US Letter and A4, as two files.
What goes in each box?
| Part of the timesheet | What to write |
|---|---|
| Day | Already printed, Monday to Sunday |
| Date | The date of that day |
| Time in, Time out | When the caregiver arrived and left, such as 9:00 am and 1:30 pm |
| Hours | The hours for that day, such as 4.5 |
| Caregiver initials | The caregiver's initials, for that day |
| Family initials | The initials of the person cared for, or of the family member who checks the hours |
| Total hours this week | The Hours column added up, at the end of the week |
| Tasks done | A tick under the day for each task done that day |
| Signatures | Both people sign and date the week by hand |
A day with no visit stays blank. If the caregiver came twice in one day, write both times in the margin and the day's hours in the Hours box.
How to fill in the timesheet
- Fill in the top lines first: the caregiver's name, the person cared for and the date the week starts.
- Each day, write the date, the time in and the time out.
- Write the hours for that day, for example 4 or 4.5.
- Both write your initials for the day: the caregiver, and the person cared for or the family member who checks the hours.
- Tick the tasks done under that day, and write on the Other line what it was.
- At the end of the week, add up the Hours column and write the total in the box.
- Both sign and date the week by hand, then keep the pages together, newest on top.
Who keeps a caregiver timesheet?
- Brothers, sisters and partners sharing a parent's care, so everyone can see who was there and when. The National Institute on Aging notes that caregiving comes with many responsibilities that can be helpful to divide up among family and friends.
- A family and a helper they arranged themselves, so both keep the same record of the hours and the tasks.
- Neighbors and friends who take turns. The NIA says help at home can come from family members, friends and neighbors, alongside formal caregivers and community services.
- The person cared for, who may want to see the week written down and initial it themselves.
What if the care is through a program?
Programs that arrange care at home have their own paperwork. Medicaid's self-directed services, for example, are offered by states under the state plan and waivers, and a home care agency or an insurance plan may have forms of its own. Our timesheet is not any of these. If the care is through a program, use that program's own form and check what it requires. A family can still keep our page as its own record of the week, alongside the official form, never in place of it.
Timesheet, checklist or daily care log?
They answer different questions, and some families keep more than one.
| Caregiver timesheet | Daily caregiver checklist | Daily care log | |
|---|---|---|---|
| What it records | Who was there, when, and for how long | Which everyday tasks were done at each time of day | What happened during the day, in words |
| How it is filled in | Times, hours and initials | Ticks | Short notes on lines |
| How long a page lasts | One week | One day | One day |
| Who reads it | The caregiver and the family | Whoever comes next | The next person on duty |
The Family Caregiver Alliance says a written schedule is useful, and when there is more than one caregiver it may even be essential to make sure all tasks are covered. For the day's tasks, our free daily caregiver checklist has tick boxes by time of day. For notes on the day, see our guide to keeping a daily caregiver log.
What this timesheet is not
It is a blank record-keeping form for the family's own use. It is not an official timesheet for any program, it does no sums, and it gives no legal advice. It holds the hours and the tasks you write, and the signatures you add by hand.
Our full Large-Print Caregiver Timesheet adds the same week starting on Sunday, two weeks on one page, a monthly hours summary with signature lines, and a notes page.
A caregiver timesheet is one of the printable forms for family caregivers that families keep together in one binder.
Frequently asked questions
What is a caregiver timesheet?
A caregiver timesheet is a page for writing down the hours a caregiver spends helping someone at home: the time in, the time out and the hours for each day, the tasks done, and the initials of both the caregiver and the family.
How do I fill out a caregiver timesheet?
Write the caregiver's name, the person cared for and the week at the top. Each day, write the date, the time in, the time out and the hours, tick the tasks done, and both write your initials. At the end of the week, add up the hours and both sign by hand.
Is this an official timesheet for Medicaid or an agency?
No. It is a blank record-keeping form for a family's own use. It is not an official timesheet for any state, Medicaid, insurance or agency program. If the care is through a program, use that program's own form and check what it requires.
Does the timesheet add up the hours?
No. The file does no sums. Write the hours for each day, such as 4 or 4.5, then add up the column at the end of the week and write the total in the box.
Where can I get a free printable caregiver timesheet?
Doctor Carissa's free timesheet is a large-print PDF in US Letter and A4, sent by email: one week with time in, time out, hours, both initials, tasks done as tick boxes and two signature lines.
Free printables come with a personal-use license: how you can use a printable.
Sources
We opened and checked every link on October 23, 2026.
- Working Successfully with Home Care Services, Family Caregiver Alliance. A written schedule is useful as well; if there is more than one caregiver, it might even be essential to assure that all tasks are covered; a notebook in the home is a way to track variations in the schedule, and the caregivers can communicate with each other or with you about how the plan is working.
- Aging in Place: Growing Older at Home, National Institute on Aging. Help at home can come from family members, friends and neighbors, supplemented by formal caregivers and community services; it includes personal care such as bathing, dressing, grooming, using the toilet, eating and moving around, household chores such as housecleaning, grocery shopping and laundry, and meals.
- Caregiver Worksheets, National Institute on Aging. Caregiving comes with many responsibilities that can be helpful to divide up among family and friends; a free worksheet for identifying and sharing caregiving tasks with others.
- Self-Directed Services, Medicaid.gov. Self-directed services are offered by states under the state plan and waivers; participants, or their representatives, have decision-making authority over certain services.
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