Older adult community assesment table
Sheet1
| Service | Distance | Answers to questions | Notes |
| Pharmacy | |||
| Grocery Store | |||
| Bank | |||
| Primary Care Physician | |||
| Hospital | |||
| Dentist | |||
| Place of Worship | |||
| Resources if unable to drive | |||
| Senior Center | |||
| Meal delivery service | |||
| Sidewalks | |||
| Parks | |||
| Veterinarian | |||
| Pet supply store | |||
| Neighborhood crime rate | |||
| Emergency Services, fire, police, EMTs | |||
| Lawn service | |||
| House cleaning |
&”Times New Roman,Regular”&16Community Assessment Required Template
pap 12/2020
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