Caregiver Organizer
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| Below is a list of information that is essential for any Caregiver to have for the one they are caring for. We recommend that you print this list and fill in all of the information pertinent to your loved one. You'll be so glad you did! |
| Personal Information for: Address & Home Phone Driver’s License or State ID number Social Security/Railroad Retirement Number Medicare/RR Medicare Number Medicaid Number
Emergency Contacts Health Care Power of Attorney Primary Care Physician Specialists (all of them)
Hospital Preference Pharmacy Closest Relative Neighbors/Living Facility Manager Friends
Geriatric Care Manager Personal Emergency Response System (e.g. Lifeline) Funeral Home Preference Medical Supply Company Home Health Service Cleaning Service Lawn Care/Snow Removal
Community Involvement Church/Clergy Adult Day Care Center Clubs/Organizations
Financial Resources Bank Trust Officer or Trustee Insurance Agent Life
Attorney Accountant Stockbroker Mortgage Company
Where to find important papers Health Information List of Prescription Medications and Dosages Health Care POA and Property POA (a copy needs to go to the hospital each time that your loved one is admitted) Will Trust Tax Records Funeral Instructions Deed/title to house Military Discharge papers Birth Certificates and Marriage Licenses
This
page information may be used on other web sites only with permission from
our site.
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