Work-impact checklist
Use the parts that fit your situation. Safety, medical care and official instructions take priority over completing the list.
- Record each missed or shortened shift
- Save the original schedule or assignment
- Note paid leave, unpaid leave and remote or modified work separately
- Keep provider work-status notes
- Ask payroll or a supervisor for factual confirmation if needed
- Save related transportation or childcare changes separately
Work record
Keep original records together and use copies when you need to annotate, share or sort them.
- Employer and job role
- Expected date and hours
- Hours actually worked
- Leave category used
- Pay-period record
- Work restriction or return-to-work note
Why this matters
A date-level record is easier to reconcile with schedules and pay statements than a single later estimate.