Please tell us about yourself. We want to help you get back to being you.
Your name or nickname
Close family and friends' names
Who lives with you?
What are your pets' names?
What are things that cheer you up? (For example, family or friends. Bring pictures.)
What makes you comfortable? (For example, extra blankets or pillows)
What makes you feel proud? (Think of activities you’ve done or your job)
What are your favorite things? (For example, certain TV shows, books, music, foods, or hobbies)
What helps you sleep? (For example, a warm or cold room temperature)
What makes you feel stressed?
What else would you like to share?
What assistive aids do you use? (Such as eye glasses, contact lenses, hearing aids, or dentures)
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