Essential Care Resource List

Here are primary contact names, phone/fax numbers and e-mail addresses for care of your loved one:

Personal Information

My loved one's home address and phone number:

Drivers license number:

Armed Forces ID number:

Social Security number:

Medicare number:

Medicaid number:

Other health/life insurance policies:

Emergency Contacts

Primary care physician:

Other specialists:

Hospital:

Pharmacist(s):

Closest relative:

Neighbors:

Friends:

Children:

Care manager:

Home health/chore service agency:

Adult day care center:

Hospice:

Personal Emergency Response System:

Manager of facility or home:

Attorney:

Accountant/financial adviser:

Medical supply company/house:

Church/synagogue:

Support group:

Banker(s):

Mortgage company:

Insurance agent(s):

Location of Important Documents

Advance directives (power of attorney, living will, etc.):

Will/trust:

Tax records:

Funeral instructions:

Deed/title: