LIFE’S CHECKLISTS · FREE WORKSHEET
Match handwashing to everyday moments
Make a reminder plan that fits your day. This is not a medical record or a scorecard.
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.
- Moment
- Before preparing or eating food
- Where I can wash
- Fictional example: kitchen sink
- My reminder
- Small note beside the lunch box
- Backup plan
- Ask where the nearest sink is when away
Date: ____________________
After using the toilet
Where I can wash
My reminder
Backup plan
Before preparing or eating food
Where I can wash
My reminder
Backup plan
After handling garbage
Where I can wash
My reminder
Backup plan
After touching pets or pet waste
Where I can wash
My reminder
Backup plan
After coughing or blowing my nose
Where I can wash
My reminder
Backup plan
Notes: