Start Assisted Living Move-In Checklist + Checklist-Style PDF

Delivery: Generates a polished final-document-style PDF and delivery page.

Customer / order contact

Your full name

Your email

Customer state

County, if relevant

Care recipient profile

Care recipient full name

Date of birth / age

Care recipient phone

Primary language / communication needs

Care recipient street address

City

State

ZIP code

Country

Primary contact / caregiver / facility

Caregiver / family contact / facility

Relationship / role

Contact phone

Contact email

Contact / facility street address

City

State

ZIP code

Country

Move-in checklist details

Move-in date

Checklist review date

Move-in purpose / checklist summary

Care routine / services / appointment notes

Belongings / room setup / clothing / toiletries / equipment

Facility paperwork / payment / admission notes

Professional assisted living move-in checklist details

Facility name / address / room

Admission paperwork checklist

Packing list: clothing / toiletries / linens

Room setup / comfort items / equipment

Medication handoff / pharmacy setup

What not to bring / restrictions

Move-in day tasks / responsible people

Questions for facility staff

Emergency, medical, provider, and insurance information

Emergency contact 1 name

Emergency contact 1 relationship

Emergency contact 1 phone

Emergency contact 2 name

Emergency contact 2 phone

Primary doctor / clinic

Preferred hospital

Insurance information

Allergies

Medications / dosage notes

Pharmacy information

Emergency contacts / providers / insurance notes

Medication / medical / allergy notes

Documents, access, preferences, and household notes

Important documents location

Access / keys / codes / home notes

Preferences, routines, pets, religious/cultural notes, comfort items

Documents / accounts / preferences / household notes

Delivery / sharing / signature notes

Additional notes

Care-sensitive: Senior and caregiving documents may involve medical information, privacy, medications, facility policies, insurance, benefits, finances, legal authority, safety, and emergency care. Midwest Legal Docs is not a law firm and does not provide legal, medical, healthcare decision, benefits, financial, facility acceptance, or care-plan approval advice.

Signature details

Optional e-signature: Type a printed name and e-signature if you want the generated PDF signature/review page filled in. Leave blank if signing after printing.

Customer printed name

Customer e-signature

Customer signature date

I understand legal/medical/facility/benefits/financial/professional review may be needed before signing, sharing, using, or relying on this document.

Prepared from customer-provided information only.

Start Assisted Living Move-In Checklist + Checklist-Style PDF.

Customer / order contact

Care recipient profile

Primary contact / caregiver / facility

Move-in checklist details

Professional assisted living move-in checklist details

Emergency, medical, provider, and insurance information

Documents, access, preferences, and household notes

Signature details