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My Personal Preferences Checklist

We originally created this checklist as an elder care preferences checklist, but then decided that people at any age may be in a situation where they cannot voice their opinions and wishes about their favorite things. For example: Imagine being in a hospital, not able to speak...but very aware of your surroundings. If a family member had your preferences written down, they could make you as comfortable as possible by surrounding you with your favorite things. We hope no one in your family ever needs to use this checklist, but in case it is needed...you'll feel confident knowing that all of your personal preferences are carried out the way you want. On this checklist we've listed a few examples, and have left room for many more. We hope this checklist helps you. :)


*Before you Print*

  • This is a one-page 8½" x 11" checklist
  • You can view this 1-page checklist by using Adobe Reader. If you don't have Adobe Reader, you can download the latest version, free.
  • Be patient while the checklist loads

Click here to open our My Personal Preferences Checklist


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