---
title: Assisted Living Facility Admission Consent Form Template | Paperform
description: Complete assisted living admission form with care assessment, medication management, fall risk protocols, and HIPAA consent. Streamline senior care facility intake with this professional template.
url: "https://paperform.co/templates/assisted-living-facility-admission-consent-form"
type: static
generatedAt: "2026-03-28T00:43:04.868Z"
---

[← Back to free form templates](/templates/)    ![Assisted Living Facility Admission Consent Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/assisted-living-facility-admission-consent-form.png)
    [Preview](https://_preview.paperform.co/ai-template/assisted-living-facility-admission-consent-form) [Use this template for free](/create?ai-template=assisted-living-facility-admission-consent-form)    [Healthcare & Medical Forms](/templates/category/healthcare/) [Healthcare](/templates/industry/healthcare/)[Senior Care](/templates/industry/senior-care/) [Nurse](/templates/role/nurse/)[Social Worker](/templates/role/social-worker/)[Healthcare Administrator](/templates/role/healthcare-admin/)[Caregiver](/templates/role/caregiver/)     About this free form template
### Streamline Assisted Living Admissions with Paperform

Admitting new residents to your assisted living facility requires careful documentation, thorough assessment, and clear consent processes. Our **Assisted Living Facility Admission Consent Form** template is designed specifically for senior care facilities, residential care homes, and memory care communities that need to collect comprehensive information while maintaining HIPAA compliance and ensuring family members understand care protocols.

#### Why This Template Works for Senior Care Facilities

This form replaces stacks of paperwork with a single, organized digital experience that families can complete before admission day. Instead of juggling multiple PDF forms, clipboards, and follow-up phone calls, your admissions team gets everything they need in one submission—from medical history and medication lists to emergency contacts and care preferences.

The template includes built-in care level assessment questions that help your clinical team understand each resident's needs before they arrive, allowing you to prepare appropriate accommodations, staffing, and care plans. Fall risk protocols ensure safety considerations are documented from day one, while medication management sections create clear expectations about how prescriptions will be handled.

#### Perfect for Assisted Living Communities and Senior Care Providers

Whether you operate a small residential care home or a large assisted living community, this template adapts to your facility's specific needs. It's ideal for:

 - **Assisted living facilities** managing admissions for independent and semi-independent seniors
 - **Memory care units** requiring specialized dementia and Alzheimer's care documentation
 - **Residential care homes** handling small-group senior living admissions
 - **Senior care administrators** streamlining the intake process across multiple facilities
 - **Healthcare administrators** coordinating between hospital discharge and assisted living placement
 - **Family caregivers** completing admission paperwork for aging parents or relatives

#### What Makes This Form Template Essential

The form is structured to gather critical information in a logical flow that mirrors the admission conversation families expect. It starts with resident demographics and emergency contacts, then moves through medical history, current medications, and functional assessments. Care preferences and family visitation wishes are captured alongside formal consent for treatment and HIPAA authorization.

Conditional logic ensures families only see questions relevant to their situation—if a resident has fall history, additional safety questions appear; if they're on multiple medications, medication management protocols expand accordingly. This creates a personalized experience that feels considerate rather than overwhelming during an already emotional time.

#### Automate Your Admission Workflow with Stepper

Once a family submits the admission form, [Stepper](https://stepper.io) can automatically trigger your entire onboarding workflow. Send the clinical assessment to your nursing team, route medication lists to your pharmacy partner, notify dietary services about special meal requirements, and create a new resident record in your care management software—all without manual data entry.

Stepper can also send personalized welcome packets to families, schedule the intake interview with your admissions coordinator, and set reminders for 30-day and 90-day care plan reviews. This automation gives your team time to focus on resident care instead of paperwork.

#### Secure, Compliant Documentation for Peace of Mind

Paperform is **SOC 2 Type II certified** and built with data security at its core, making it suitable for handling sensitive healthcare information (note: Paperform is not HIPAA compliant for PHI storage, but works well for initial intake and consent). All submissions are encrypted, and you can set up role-based access so only authorized team members see resident information.

The form includes clear HIPAA authorization language and treatment consent sections that create a documented audit trail for regulatory compliance. You can export submissions as PDFs for resident files or connect to your document management system via Stepper or other integrations.

#### Save Time and Reduce Admission Errors

Senior care facilities using digital admission forms report significant time savings—what once took multiple in-person visits or mailed packet exchanges now happens in one online session families can complete from home. Pre-filled medication lists mean fewer transcription errors, digital signatures eliminate lost paperwork, and automatic submission notifications keep your admissions team in the loop immediately.

The calculation and conditional logic features can also flag high-risk residents who need additional assessment or specialized care arrangements before admission day, preventing last-minute scrambles or unsafe placements.

#### Customize for Your Facility's Unique Care Model

Every assisted living facility has different care philosophies, amenities, and protocols. This template gives you a professional starting point that you can customize in minutes using Paperform's intuitive editor. Add your facility logo, adjust questions to match your care levels, include photos of your community, and modify consent language to align with your state regulations.

You can embed the form directly on your facility website, send it via email to families beginning the admission process, or provide a QR code at tours and informational sessions. Custom success pages can provide next steps, welcome videos from your executive director, or links to schedule a move-in day.

#### Trusted by Healthcare Providers Nationwide

Paperform powers over 500,000 teams worldwide, including healthcare providers, senior care facilities, and medical practices that need secure, professional forms without the complexity of traditional healthcare software. Our platform combines enterprise-grade security with the simplicity that small care teams need to move quickly.

Start streamlining your assisted living admissions process today with this comprehensive, customizable template—and give families a modern, compassionate intake experience during a significant life transition.
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