Instructions:

Step 1

Complete the checklist for yourself or for someone else, such as an older family member or someone you care for.

Step 2

Set aside some time to sit down and complete the checklist (about 1 hour). Don't worry if you can't finish it all at one time; you can click "Save Progress" at any time and your answers will be saved. You will need to provide an email address (which we will not be able to see). The site will send you a link to continue when you're ready. You'll need to return within 30 days using that link.

Step 3

As you respond, suggested resources will sometimes appear when you select “No”. Do not worry about opening these right away; they will also be provided in a list to you on your ‘Summary’ page.

All responses are optional. If a question is not applicable to you, you may leave it blank.

Step 4

After you complete the checklist, your summary will be provided, including the resources suggested for you based on your responses. You can email the Summary page to yourself. All available resources can also be found in the Resource Library.

Download PDF

Want to download a PDF of the checklist and complete offline?