Legal Documents Assessment

Welcome to Toghers Legal Documents Assessment

This brief questionnaire will help you to determine if all of the recommended legal documents are in place for the person you care for. This should take you about 2 minutes to complete. Once you have submitted your response, you will receive an email with a Legal Documents Summary - identifying the documents you need to have in place and why.

In order to provide you with the best feedback - we have made some responses required. These are marked with a red asterisk.

1.

Is there a durable medical power of attorney in place for your care recipient?

2.

When was this document put in place?

3.

Is there a legal power of attorney in place for your care recipient?

4.

When was this document put in place?

5.

Is there a Living will in place for your care recipient?

6.

When was this document put in place?

7.

Is there a Do Not Resuscitate Order in place for your care recipient?

8.

Is a copy kept prominently in the home and on the person at all times?

	Yes
	No
	They wear a DNR ID
	Why would we need to do this?

9.

Is there a Financial will in place for your care recipient?

10.

When was this document put in place?

11.

Has your care recipient completed a Five Wishes Document to make their end of life and care wishes known?

12. Please give your name as you would like it to appear on your Legal Documents Summary

13. We will be emailing your Legal Documents Summary to you. Please enter the email address where you would like this to be sent: Required Question

14. Would you also like us to send you special offers from Toghers?
(Earning your trust is very important to us - we do not share your email with anyone)

	Yes
	No

Thank you for completing Toghers Legal Documents assessment. You will receive your Legal Documents Summary shortly.

When you submit your response you will be back at the Toghers website. Be sure to become a Toghers member so you can chat free with a Caregiver Coach to get help with your unique Caregiving questions.

	Yes
	No
	I don't know
	I don't know what this is
	I don't know if I need this

	Within the last year
	Within the last five years
	Withinthe last ten years
	More than ten years ago
	I'm not sure

	Yes
	No
	I don't know
	I don't know what this is
	I don't know if I need this

	Within the last year
	Within the last five years
	Withinthe last ten years
	More than ten years ago
	I'm not sure

	Yes
	No
	I don't know
	I don't know what this is
	I don't know if I need this