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T H E C A R E G I V E R ’ S T O O L K I T
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CHAPTER 3
LEGAL & FINANCIAL CONCERNS
Many of us don’t like to think about gathering all of our important documents
in one place. It is easy to put it off until tomorrow or to assume that our loved
ones will know “where everything is” should the time come. No one can predict when an emergency situation might
occur, and if unprepared, a person or family may face a much greater burden and expense in resolving legal affairs.
This checklist includes a comprehensive list of important documents and information related to every aspect of
your life. Completing this will help you to ensure that you have planned effectively to keep track of your legal affairs,
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mind for yourself and for those who care about you!
My Checklist
MY INFORMATION
FULL NAME
SOCIAL SECURITY #
DATE OF BIRTH
PLACE OF BIRTH
ORGAN DONOR?
Yes
No
FATHER’S NAME & PLACE OF BIRTH
MOTHER’S MAIDEN NAME & PLACE OF BIRTH
MY SPOUSE’S/PARTNER’S INFORMATION
FULL NAME
SOCIAL SECURITY #
DATE OF BIRTH
PLACE OF BIRTH
ORGAN DONOR?
Yes
No
FATHER’S NAME & PLACE OF BIRTH
MOTHER’S MAIDEN NAME & PLACE OF BIRTH
MY EMERGENCY CONTACT INFORMATION
EMERGENCY
CONTACT
NAME
PHONE #
POWER OF
ATTORNEY
NAME
PHONE #
CRITICAL CONTACTS
NAME
ADDRESS
PHONE #
Physician
Physician
Physician
Pharmacy
Pharmacy
Clergy
Dentist
Veterinarian
OTHER:
Harford County Department
of Community Services
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