Legacy Senior Network Checklist
A comprehensive planning checklist to support your next steps in senior living, care, and family readiness.
Personal Information
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Age
*
Who are you preparing for?
*
Myself
Parent(s)
Spouse
Family Member
Client
Other
Please specify who you are preparing for:
*
Current Life Snapshot
How would you describe your current situation?
*
Living independently
Living with family
Considering retirement community / senior living
Receiving in-home support
Managing health changes
Other
Please specify your current situation:
*
What is your biggest concern right now?
*
Top 3 priorities today
Priority 1
*
Priority 2
Priority 3
What’s Your Next?™ – Vision
Where are you living in your ideal future?
Who are you surrounded by?
What does your day-to-day life feel like?
What brings you peace and fulfillment?
Goal Planning
10-Year Vision
5-Year Plan
1-Year Plan
Readiness Checklist
Readiness Checklist
Housing/Living situation is clear
Family has discussed future plans
Finances and budget are understood
Key legal and estate documents are in place
Health care and support needs are considered
I have a general plan but need help with details
I have not started planning yet
Support Needed
Areas where you would like support
Understanding senior living options
Navigating health care and care coordination
Organizing finances and benefits
Legal and estate planning guidance
Family communication and decision-making
Emotional support/coaching through transitions
Other
Please specify the support you need:
Final Reflection
What would make this next chapter successful for you (or your loved one)?
What worries you most about the future?
Submit Checklist
Should be Empty: