Setup Worksheet
The following information will be needed to setup a new CareCalendar. Please take the time to gather this information before continuing with the setup process.After you have gathered this information, continue setting up a
COORDINATOR
- Name: _________________________________
- Email: _________________________________
- Phone: _________________________________
RECIPIENT
- Name: _________________________________
- Street: _________________________________
- City, State, Zip: __________________________
- Email: _________________________________
- Phone: _________________________________
CARE DATES
- Start date: ___/___/_____
- Estimated End date: ___/___/_____
NEEDS
Determine the type of help that is needed and provide general details about those needs. Use the following as a guide:
Childcare- Number of children :
Ages :
Allergies :
Special needs :
Preferred care location :
Other pertinent information about the child(ren) :
________________________________________________________
________________________________________________________
________________________________________________________ - Errand
________________________________________________________
________________________________________________________
________________________________________________________- Housework
- Type of housework needed :
Chemical sensitivities :
Cleaning supplies and equipment provided : Yes/No
________________________________________________________
________________________________________________________
________________________________________________________ - Meal
- Usual meal time :
Number of people eating :
Food sensitivities :
Diet restrictions :
Favorite Foods :
Specific Dislikes :
Microwave available? : Yes/No
Freezer space available? : Yes/No
________________________________________________________
________________________________________________________
________________________________________________________ - Ride
________________________________________________________
________________________________________________________
________________________________________________________- Visit
- Visiting hours :
________________________________________________________
________________________________________________________
________________________________________________________ - Yardwork
- Equipment provided? : Yes/No
________________________________________________________
________________________________________________________
________________________________________________________
If so, gather a list of names and email addresses for 'personal helper' access.
After you have gathered the information on this worksheet, return to http://carecalendar.org and continue with setting up a new calendar.
