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Solutions 2 Go logoSenior Lifestyle Concierge
Check your fit

A short, respectful questionnaire.

Your answers help us confirm whether Senior Lifestyle Concierge is the right kind of help—no pressure, no obligation.

Is Senior Lifestyle Concierge right for my loved one?

This questionnaire takes about 5 minutes. Answer as honestly as you can.

About you

Do you have the senior’s permission to request services?
Will you be the person responsible for booking?
Will you be the person responsible for payment?
Would you like to receive authorized service-completion updates?

About the senior

Living situation

Does the senior live alone?
Currently living in an assisted living facility?
Are there pets in the home?
Are any pets aggressive or difficult to control?

Services needed

Independence and mobility

Can the senior make and communicate their own decisions?
Can they manage bathing, dressing, toileting, and grooming without our assistance?
Can they safely walk independently or with their own cane or walker?
Can they safely enter and exit a standard passenger vehicle without being lifted?

Medical and personal-care boundaries

Any “Yes” answer below may mean the requested help is outside our nonmedical scope. We’ll still follow up personally.

Requires skilled nursing
Requires medication administration
Requires wound care
Requires IV, catheter, or feeding-tube care
Requires bathing, dressing, toileting, or incontinence assistance
Currently receiving hospice care
Requires overnight care
Requires lifting or transfers
Requires continuous supervision
Wanders or becomes disoriented outside the home
Requires secured dementia supervision

Home and visit safety

Has fallen within the past 12 months
Has been diagnosed with dementia or Alzheimer’s disease
There are firearms in the home
Aggressive or disruptive pets are present
Excessive clutter, hoarding, mold, or pest concerns in the home
Are all firearms secured?
Willing to ensure no smoking, cannabis use, or vaping occurs during the visit?
Willing to secure aggressive or disruptive pets during the visit?

Payment and policies

Do you understand services cost $69 per one-hour block?
Do you understand travel-heavy services require a two-hour minimum?
Do you agree to pay 50% at booking?
Do you authorize the remaining balance to be charged at completion?
Do you understand parking, tolls, purchases, and applicable premiums are separate?
Do you understand that Senior Lifestyle Concierge does not provide home health, personal care, nursing, medical care, or emergency services?

Family communication authorization

The senior must authorize family communications unless another lawful arrangement applies.

Anything else we should know?

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