Free Caregiver Handoff Sheet: Everything a Helper Needs on One Page

Every caregiver needs a break, but it's hard to step away when everything lives in your head. This free one-page sheet captures what a family member, friend, or respite worker needs to know: medicines, the daily routine, food, safety, what brings comfort, and when to call you. Fill it in once, print it, and update it as things change.

My Caregiver Handoff Sheet
Everything a helper needs to know, on one page.
About My Loved One
Medicines
TimeMedicineDoseNotes
Daily Routine
Time of dayWhat usually happens
Morning
Midday
Afternoon
Evening
Night
Good to Know
Thank you for giving a caregiver a break. Chances.org

🔒 Nothing you type here is saved or sent anywhere. It stays on your screen only, so print before you leave this page. Want to write by hand? Just press Print without typing anything.

Tips for a smooth handoff

  • Walk through it together before you leave, especially the medicines and anything about safety.
  • Set out the week's medicines in a labeled pill organizer if you can.
  • Keep it with the medication list and emergency contact sheet on the fridge.
  • Then truly rest. Trust your helper, and try not to check in every hour.

Looking for someone to give you a break? Your local Area Agency on Aging can tell you about respite care. Call the Eldercare Locator at 1-800-677-1116. See also our printable Medication List and Emergency Contact Sheet.

Sharing chances creates good karma 😃