Comfort Questionnaire

What Type of Care do You Need?

Take our Care Questionnaire

Step 1: Complete our Care Questionnaire to receive our care recommendation for you or your loved one.

Step 2: After completing the Care Questionnaire, you will have the choice to:

Schedule a full assessment with a senior living counselor to validate your results and discover if comfort keeper is right for you
Print or email the results

For more information on how to get an immediate recommendation about what level of care you need, watch our Care Questionnaire video.

Our senior living counselors are experts who are here to answer any senior care questions you may have. After completing the questionnaire, you can schedule a full assessment, which will be conducted by one of our healthcare professionals to validate your results and discover if comfort keeper is right for you. Please read our confidentiality promise before proceeding.

What Type of Care do You Need?

Take our Care Questionnaire

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Comfort Careers

What type of care do you need?

I am taking this Care Questionnaire for:

Are you experiencing any of the following?
(Check all that apply or if none, click next)

Have you stayed in any of the following in the last 6 months?
(Check all that apply or if none, click next)

Are you still under a doctor's prescribed regime/care plan?

Do you need someone to help you with any of the following?
(Check all that apply or if none, click next)

Do you have difficulty remembering things such as paying your bills each month?

Have you ever been diagnosed with dementia or Alzheimer's?

Have you ever wandered or driven away from a known location and felt disoriented or lost?

Does your loved one require in-home support 24 hours a day?

Is your loved one experiencing any of the following?
(Check all that apply or if none, click next)

Has your loved one stayed in any of the following in the last 6 months?
(Check all that apply or if none, click next)

Are they still under a doctor's prescribed regime/care plan?

Does your loved one need someone to help them with any of the following?
(Check all that apply or if none, click next)

Is your loved one having difficulty remembering things such as paying their bills each month?

Has your loved one ever been diagnosed with dementia or Alzheimer's?

Has your loved one ever wandered or driven away from a known location and felt disoriented or lost?

Get In Touch

Speak with a senior resource counselor to discuss your results or request a full assessment.†

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