(Identical to Technician Report)

Name of Clinic

Month, Year

---

Name of Assistant Technician
Phone #
​Email

Total Earnings: $
​Enter Date of Disbursement

---

​Baseline Assessments
Total: ​#

Date     Client's Name     Phone #

Date     Client's Name     Phone #

​Date     Client's Name     Phone #

---

​Follow-Up Assessments
Total: #

​Date     Client's Name     Phone #

Date     Client's Name     Phone #

​Date     Client's Name     Phone #

---

​Fitness Trainings
Total: ​#

​​Date     Client's Name     Phone #

Date     Client's Name     Phone #

​Date     Client's Name     Phone #

---

Clinic Reports

---

Month, Year = June, 2025 (example)

The Name, Phone #, and Email of Assistant Technicians must be preserved if/when he is deleted from providing Services at this Clinic.

Total Earnings = The total amount ($) that the Assistant Technician earned during this month by providing Services at this Clinic.

The owner Technician enters the Date that he transfers the Assistant Tech's Earnings for the Month.

• The Field should say: "Pending" until the Disbursement Date is entered.

Client's Name = LastName, FirstName

Clients are listed in chronological order by Date of Service

Clinic Reports