Forms
In various places in this website, reference is made to forms, documents, and spreadsheets such as the Membership Form, Good Neighbor Initiative Request Form, and Medical Emergency Information Form.
Some of these appear below. Any form that has a green Submit button at the bottom can be completed on your computer and sent by clicking Submit. Some forms lack a Submit button and must be printed, filled out by hand, and then placed in EBA mail slot 178, or posted in your home.
Any form, document, or spreadsheet, including those that can be submitted online, can be printed if you prefer a hard copy. However, print procedures can vary depending on the type of printer and/ or computer you're using (whether an Apple product or a PC), and on whether you wish to print a form, document, or spreadsheet.
This can be frustrating, especially for members who are less-experienced computer users. For this reason, you have three options if you wish to print a form.
Send a request for a hard copy to LAW’s email address: agingwell5555@gmail.com. Include the name of the form and your in-house mailbox number. LAW will print a copy and place it in your mailbox.
Email us at agingwell5555@gmail.com and ask us to come to your apartment and demonstrate how to print the form.
If you’re already a fairly experienced computer user and are willing to go through some trial-and-error, you may wish to try to print the form yourself. Here are a few things you need to know before you get started:
Mouse over the upper right-hand portion of the document, form, or spreadsheet and click on the pop-out icon that appears
The document will reappear.
Give the print command by holding down the Command key on an Apple computer or Ctrl on a PC and pressing the letter P. At this point you will need to navigate one or more print dialogs and command buttons (“Print”, “Next,” etc.). If you are successful, congratulations. If not, please let us know by email (see below) or putting a note in in-house Mailbox 178.
LiveAgeWell Good Neighbor Initiative Agreement
What is the purpose of the LiveAgeWell Good Neighbor Initiative Agreement?
This agreement has been created to set expectations and bring clarity to the relationship between the giver and receiver of services. It asks for contact information for both participants and identifies the nature of the services to be provided. It also lays out a protocol for handling emergencies. You will note that there is no provision for providing any kind of direct physical assistance in the event that your buddy has become incapacitated or unconscious, as it is very important that you not try to intervene. Following the protocol will ensure that appropriate help is summoned.
It is strongly recommended that each GNI participant retain a copy, and to file one with building management or LiveAgeWell. A hard copy can be obtained from LiveAgeWell.
Medical Emergency Information Form
What is the purpose of the Medical Emergency Information Form?
This form collects most of the information likely to be needed in a health emergency, including identifying information for the resident and his or her physicians. Health insurance companies, emergency contacts, medications, and other important information can also be recorded.
Many people post such information on their refrigerators or other conspicuous location in anticipation of emergencies, and it is our recommendation that both buddies who have entered into a Good Neighbor Initiative Agreement do the same.
A hard copy can be obtained from LiveAgeWell. Put a note in Mailbox 318, and you will be supplied with one.
NOTE: LiveAgeWell highly recommends that you place a filled-out, hard copy of the Medical Emergency Information Form and posting in a prominent place in your home. This will ensure that EMS (Emergency Medical Services) personnel are in the best position to help should they be called if you experience a medical emergency. To view the entire form, use the slide bar to the right of the form.
Practitioner Order for Life-Sustaining Treatment
The POLST (Practitioner Order for Life-Sustaining Treatment) form that follows should be completed with a health care provider if you or a person for whom you are responsible is at risk for a life-threatening clinical event because of a serious life-limiting medical condition, which may include advanced frailty.