Appointment Information: Date & Time

Are the caretakers likely to switch or change?*

Does the individual have any mobility limitations?*

Are there any cognitive concerns or conditions we should be aware of?*

Is the individual able to operate smart devices independently?*

Would you like assistance in programming medication and doctor appointment reminders into the system? Please note: We do not collect or store any medical information. Our role is to assist you in inputting reminders for medication and medical appointments*

Do you want to connect your smart TV?*

Do you have the attached email account for the TV?*

Do you want to connect household items?*

If yes, please specify which items you would like to connect (e.g., lightbulbs, blinds, kitchen items)*