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Free caregiver printable

Caregiver’s Own Page

Make sure responders and trusted helpers know that someone depends on you and who should step in if you are suddenly unavailable.

2 pages · US Letter · Print in color or grayscale · Fill in by hand

Preview of the two-page Lighthouse Caregiver's Own Page emergency backup printable

Plan for the caregiver’s emergency too

Family caregivers often build detailed plans for the person they support but leave their own unexpected illness, injury, or hospitalization unaddressed. This page makes that hidden dependency visible to responders and trusted helpers.

It records the caregiver’s essential health information, the people who should take over, and the needs that cannot wait for the person receiving care. A second page includes medicines, meals, safety concerns, routines, and pet care.

Create a backup that can actually activate

  1. Ask each backup person whether they are willing to be called and confirm who has a key.
  2. Write only the immediate care needs; point helpers to the emergency card and daily routine for fuller details.
  3. Keep a wallet card or phone note stating that you are a caregiver and naming the first backup contact.

Review the plan with the people listed and update it whenever phone numbers, access, medicines, routines, or pet needs change.