Client job order intake form

Non-Clinical Temporary Staffing Agency | PublicProof Academy working document

Capture every detail of a client job order in writing before any temp is dispatched.

Business

State or jurisdiction

Prepared on

Owner

Official source saved

Next review

Client and site

Client legal name and billing contact
Worksite address and parking/entry instructions
Supervisor who approves time (name, phone, email)
Safety contact at the site
Signed master services agreement on file

Position details

Job title and duties in plain words
Workers' comp class code confirmed for these duties
Pay rate and bill rate (from burden calculator)
Shift days, start and end times, breaks
Expected length of assignment
Number of temps needed and start date

Requirements and safety

PPE required and who provides it (never charge temps where prohibited)
Site-specific safety training the host will give
Hazards disclosed by the client
Background check or drug screen required (with consent forms)
Any request that screens by protected traits refused and documented

Approvals

Credit limit or deposit set
Conversion fee disclosed in writing
Order accepted by (name and date)

Use rule: Education and organization only. Record the agency, official source, checked date, cost, proof saved and responsible person for every consequential requirement. Unknown means stop and confirm. Example rows are labeled EXAMPLE and are not your data.