Before we begin · Step 1 of 5
You decide what to share.
A few questions can help organize your care search. Start at your own pace — you don’t need to have every answer.
Your choices come first.
Exploring care needs does not send a referral. An introduction to a care provider requires a separate review and your permission.
Getting to know them · Step 2 of 5
Tell us about your loved one.
Let’s start with their everyday life and what matters to them. A full legal name, date of birth, or street address isn’t needed here.
A nickname is enough.
Please leave out medical records, medication lists, and other sensitive details.
Everyday support · Step 3 of 5
What help is needed day to day?
Choose what best describes the support needed now. “Not sure” is always a useful answer.
These answers guide a conversation. A care provider still needs to assess individual needs and confirm what they can support.
Finding the right fit · Step 4 of 5
Where, when, and what feels right?
Care at home or a care community — let’s understand the options you’d like to explore.
Include housing and care where applicable.
Your answer does not establish coverage or eligibility.
An urgent timeline needs direct follow-up. This questionnaire does not arrange immediate care.
Your care search · Step 5 of 5
Does this sound right?
Take a moment to review your answers. You can change anything before discussing care options.