LIFE’S CHECKLISTS · FREE WORKSHEET
Aging service comparison
Organize administrative questions and next actions. Keep identity numbers, clinical records and children’s identifying information in the responsible organization’s secure process. This is a planning worksheet, not an official application or authorization.
First read the completed example. Then write your own answers in the blank sections. If you do not know an answer, write what you need to ask. Official applications may require their own forms.
Completed example
This is a fictional practice entry. Write your own details in the blank sections below.
- Service / office
- Fictional community transport office
- Address served
- Office confirms neighborhood is served
- Availability / waitlist
- Next week's rides require advance booking
- Written cost / eligibility questions
- Example quote $4/ride; eligibility being checked
- Permission required
- Rider consent for booking
- Next contact
- Call Monday to confirm accessible vehicle
Date: ____________________
Item 1
Address served
Availability / waitlist
Written cost / eligibility questions
Permission required
Next contact
Item 2
Address served
Availability / waitlist
Written cost / eligibility questions
Permission required
Next contact
Item 3
Address served
Availability / waitlist
Written cost / eligibility questions
Permission required
Next contact
Item 4
Address served
Availability / waitlist
Written cost / eligibility questions
Permission required
Next contact
Notes: