**Respite and Supported Community Living notes contain confidential information and are therefore not available on our website.
2017 Due Dates and Pay Dates
List of due dates for notes and the pay dates for 2016
2017 Federal W4
If you need to change the amount being withheld from each paycheck for Federal taxes
2017 Iowa W4
If you need to change the amount being withheld from each paycheck for State taxes
Background Check Consent Form
Must be completed at the employee’s annual review. If an employee provides Respite in their own home, we must complete a background check on any other individuals living in the home, over the age of 18.
Consumer Information Update Form
Changes to individual’s information
Change of Personal Information
Name, address, phone number and email changes
Direct Deposit Form
Notify us of any changes to your bank account information. Your signature is required on this form.
Complete when an incident occurs during a shift
Tracking Tool – Sample
Track hours used so you don’t exceed the approved amount
Tracking Tool – Yearly
Track hours approved on an annual basis (ID Respite only)
Tracking Tool – Monthly
Track hours approved on a monthly basis (SCL for all Waivers, BI & HD (IH) Respite)
Complete for each training completed or if attending a REQUIRED meeting in order to be paid