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In order to assist our staff in providing individualized, meaningful care to the residents who have made Northwood their home, we request that you, as a key member of the care team, provide us with a brief historical profile of the resident you represent. This biography as well as the "Life Story Book" we hope you will be interested in (please see last page), will provide us with important information to incorporate into their life with us. This will enable us to provide care that is geared to their particular needs, interests and enjoyments in life.

Note to friends and family members filling out the biography on behalf of a resident, please read the "you" in all questions as meaning the resident, as if they were filling out the form for themselves.

Name of Resident: Room No:
Name by which (you/they) prefer to be called:

DAILY ROUTINE

1.
a. What time do(es) (you /the resident) like to get up in the morning?



b. Do (you) prefer to stay in......

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Approximate Word Count: 1081
Approximate Pages: 5 (250 words per double-spaced page)

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