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Run: Person-Centered Bathing Preferences Form

Person-Centered Bathing Preferences Form captures a resident or patient’s bathing schedule, comfort, caregiver, and environment preferences in one place so s...

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Purpose and Consent

I understand these preferences will be used by authorized care staff to support bathing care (required)

Yes No N/A

Preferred contact for follow-up questions

Additional notes or accommodations

Use this field only for bathing-related accommodations or preferences. Do not include unnecessary PII.

Bathing Schedule

Preferred time of day for bathing

Preferred bathing days

How flexible is the bathing schedule?

Bathing Method and Comfort

Preferred bathing type (required)

Please describe any details for the selected bathing type

Preferred water temperature

Comfort items or supports during bathing

Caregiver Preferences

Preferred caregiver gender

Reason for caregiver gender preference

Privacy or dignity considerations for bathing support

Music and Environment

Would you like music during bathing?

Preferred music type or station

Environmental preferences

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