Personal History Template

The Personal History Template provides dementia caregivers thorough and consistent information about the person in their care who is living with dementia. It includes information about his or her background, preferences, hobbies, doctors, medications, schedules, and more.

All members of the caregiving team – family members and professionals – should have an up-to-date copy of this personal history. Post a copy in a prominent place in a common area so that this information will be available to anyone who interacts with the person with dementia.

Click below to download the Personal History Template. The download is free.