Eldercare Info Organizer

Caring for another, whether full-time or part-time, means keeping track of many details. This list can help you organize useful information in one place. You may want to create an online copy to share with other family care providers. Plan to update this list regularly, especially with any medical information.

Personal Information

• Date of birth/birth certificate
• Social Security number/card
• Veteran status, VA ID number, military records, discharge papers

Personal Contacts

• Care-receiver: Name, address, phone
• Clergy: Address and phone
• Doctors: Names, addresses, phone numbers
• Dentist: Name, address, phone
• Other health care providers: Name, address, phone, and the scope of their care
• Pharmacy: Name, address, phone
• Attorney: Name, address, phone
• Accountant: Name, address, phone
• Transportation services: Phone, website

Financial Information

• Other insurance policies and policy numbers, including auto, homeowners or renters, long-term care, disability, life
• Checking and savings accounts, bank names, account numbers, balances
• Sources and amounts of monthly income
• Monthly expenses, such as mortgage or rent, community services, utilities, phone, insurance premiums, car payment
• Other debts or recurring fees
• Other assets (real estate, liquid assets, etc.)
• Safety deposit box location, number, keys
• Location of, copy of, or actual documents, including: Will, living will, tax records, durable power of attorney, passport, marriage license, divorce decree, car title, rental agreements, address book (contact info for friends/colleagues), burial instructions/plot, etc.

Medical History

• List of all medications, dosages, frequency, and who prescribed it for what condition
• Allergies and adverse reactions to specific medications
• Medical history, including surgeries, medical procedures, chronic conditions
• Health insurance policies, company names, policy numbers, including Medicare and Medicaid

The content is for general information purposes only, and you are urged to consult a legal or financial advisor concerning your own situation and any specific questions you may have. Cigna Healthcare^SM assumes no responsibility for any circumstances arising out of the use, misuse, interpretation, or application of any information supplied here.