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Personal Data Sheet Assisted Living Mobile App

This Personal Data Sheet Assisted Living Mobile App makes it easy for residential facilities to keep accurate resident records and personal data sheets for improved residential care. For nursing homes and other long-term care providers, use this app to enhance personal care of facility residents. Community-based care for assisted living, like a retirement community, often involves residents with Alzheimer and dementia diagnoses. Use this app to track personal data of these patients, in order to best take care of residents in what can also be a nursing facility for older adults with cognitive impairment.

This app is filled out using a smartphone or tablet. Once completed is stored securely for your facilities' records. The app can be made HIPAA Compliant.

  • Lendlease
  • The Cooperative
  • PG&E
  • oxy
  • Red Bull
  • Mirvac

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Take a peek inside the Personal Data Sheet Assisted Living Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico textbox

    Facility Name

  • Ico multiline

    Location

  • Ico textbox

    Phone

  • Ico textbox

    Contact

  • Ico textbox

    Title

  • Ico textbox

    Name

  • Ico date

    Birth Date

  • Ico date

    Admission Date

  • Ico textbox

    Room Number

  • Ico textbox

    Table Number

  • Ico textbox

    Resident Phone Number

  • Ico textbox

    COR Status

  • Ico textbox

    Religion

  • Ico textbox

    Mortuary

  • Ico multiline

    Diagnosis

  • Ico multiline

    Allergies

  • Ico textbox

    Ambulance

  • Ico textbox

    Hospital

  • Ico integer

    Medicare Number

  • Ico textbox

    Medical Record Number

  • Ico textbox

    Social Security Number

  • Ico textbox

    Primary Insurance Company

  • Ico textbox

    Primary Insurance ID

  • Ico textbox

    Policy No.

  • Ico textbox

    Secondary Insurance Company

  • Ico textbox

    Secondary Insurance ID

  • Ico textbox

    Policy No.

  • Ico textbox

    Name

  • ...and More!

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