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Run: Resident Life Story and Biography Intake

Capture a resident’s life story, preferences, and legacy details in one guided intake form for senior living communities. Use it to personalize care, support...

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Introduction and Consent

Consent to collect and use this biographical information for resident care and engagement (required)

By checking this box, you confirm that the information provided may be used by the care team for resident-centered activities, care planning, and family engagement.

Yes No N/A

Your relationship to the resident (required)

Your name (required)

Your email address

Optional. Used only if we need to follow up about missing or unclear information.

Resident Basic Details

Resident full name (required)

Preferred name or nickname

Date of birth

Optional. Only provide if needed for identity matching or care coordination.

Place of birth

Current room or unit

Optional. Helps staff connect the biography to the resident record.

Childhood and Early Life

Describe the home or neighborhood where you grew up

Parents or guardians

Include names or roles only if you are comfortable sharing them.

Siblings

List names, birth order, or a brief description of sibling relationships.

Favorite childhood memories

Any early life challenges or important events

Optional. Share only what you want the care team to know.

Education and Work History

Education history

Career or work history

Proudest achievements

Military service or public service

Optional. Include branch, role, or service highlights if relevant.

Family, Relationships, and Community

Spouse or partner

Children

Include names and any relationship details you want staff to know.

Grandchildren or other important family members

Close friends or support people

Optional. Useful for visits, calls, and care coordination.

Community, faith, or volunteer involvement

Interests, Preferences, and Daily Life

Hobbies and interests

Favorite music, artists, or genres

Favorite foods or beverages

Daily routine preferences

Preferred way to communicate

Legacy, Values, and Final Notes

Values, beliefs, or guiding principles

Important life lessons or advice you would like remembered

Message you would like family or staff to remember

Anything else we should know

Optional. Please avoid including sensitive medical details unless they are necessary for care and you consent to sharing them.

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Email (required)

Your name (optional)

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