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Forms (PDFs)

Form 1: Successful Aging Checkup
Form 5: Checklist for Reducing Your Risk of Falling
Form 6-A: Home Safety Inspection Checklist
Form 6-B: Home Repairs and Home Modifications Checklist
Form 7: Checklist for Older Drivers
Form 9: Needs Assessment for Living on Your Own
Form 10: Worksheet for Hiring a Home Helper
Form 11: Checklist for Choosing a Home Health Agency
Form 13: "Is It Time to Move?" Retirement Housing Planning Sheet
Form 14: Worksheet for Evaluating a Senior Living Community
Form 15: Retirement Living Move-in Guide
Form 17: Checklist for Communicating Clearly with Your Doctor
Form 18-A: List of Current Medications
Form 18-B: Medications Check-off List
Form 24: Personal Values Statement
Form 25: Worksheet for Evaluating a Nursing Facility
Form 26-A: Nursing Facility Move-in Checklist
Form 26-B: Resident/Family Care Conference Worksheet
Form 27: Worksheet for Questions, Concerns and Complaints
Form 28: Confidential Personal Information
Form 33: Checklist for Selecting Long-Term Care Insurance
Form 37: Checklist for Selecting a Hospice or Palliative Care Provider
Form 38: Funeral or Memorial Service Planner
Form 40: Family Meeting Planner
Form 42: Checklist for Selecting and Working with a Geriatric Care Manager
Form 45: Health Care Representative's Discussion Checklist

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2004 Aging In Stride