Take a pen and a few useful questions to your parent’s home. These printable tools turn observations into named actions, leave room for your parent’s priorities, and keep unfinished work visible.
Choose the sheet that fits your visit.
6 pages · Preview PDFFor a room-by-room visit
The home visit workbook
22 observations across the usual routes, bathroom, bedroom, steps, kitchen, and family follow-up. Includes a next-step page and source notes.
- Notice
- Discuss
- Assign
6 pages · PDF · blank handwriting worksheet · no account
1 page · Preview PDFFor a focused first conversation
The first-visit quick check
Ten observations, an agreed action, and one owner. Start here when you want a practical paper copy without carrying the full workbook.
- Check
- Choose
- Follow up
1 page · PDF · blank handwriting worksheet · no account
2 pages · Preview PDFFor several helpers or unfinished work
The family action record
Three spacious action cards and a separate follow-up page. Record requested, booked, completed, and checked work without squeezing notes into tiny cells.
- Name an owner
- Record progress
- Review
2 pages · PDF · blank handwriting worksheet · no account
A small detail makes a better note.
TOO VAGUE TO ACT ON
“Fix the bathroom.”
A USEFUL NEXT STEP
“Ask an assessor about shower support. Alex will arrange the visit by Friday. Keep the issue open until advice and any fitting are followed through.”
This is an illustrative planning example, not advice about a particular person or a recommended installation.
Before you print
- Choose your paper. US Letter is 8.5 × 11 inches; A4 is 210 × 297 mm.
- Check the preview. Select actual size. The pages have generous margins and work in black and white.
- Bring a pen. Use the notes to start a conversation; ask permission before changing the home.
- Keep the current copy. Agree who stores it and when you will revisit. Avoid private health details on sheets shared with helpers.
What these worksheets can tell you
They record household observations and agreed work. They do not certify a safe home, calculate a clinical fall-risk score, or replace an individual assessment. Do not test a difficult transfer or rely on an unstable rail to finish a check.
Safety observations draw on CDC STEADI materials and Mayo Clinic fall prevention guidance; family coordination prompts are editorial tools. Read our editorial policy.
Prefer to keep notes on your device?