Assisted Living Family Portal Access Request Form

Managing care for a family member in assisted living requires constant communication and access to important health information. Our Assisted Living Family Portal Access Request Form makes it simple for family members and authorized caregivers to request secure online access to electronic health records (EHR), care plan updates, physician orders, and billing statements—all in one convenient location.

This form template is designed specifically for assisted living facilities, senior care communities, and healthcare administrators who need to streamline the family portal onboarding process while maintaining HIPAA-compliant access controls. By digitizing your access request process with Paperform, you can eliminate manual paperwork, reduce administrative burden, and provide families with faster access to the information they need.

Why this template works for assisted living facilities:

Family members complete a single, comprehensive form that captures resident information, relationship verification, requested access levels, and necessary consent documentation. The form includes conditional logic to show relevant fields based on the type of access requested, ensuring families only see questions applicable to their situation.

Once submitted, you can use Stepper (stepper.io) to automatically route requests to the appropriate department—whether that's IT for portal provisioning, compliance for verification, or billing for financial access—keeping your team coordinated without manual handoffs. Stepper can also send automated follow-up emails with login credentials, trigger background check workflows for certain access levels, and create tasks in your facility management software.

For facilities managing multiple residents and family members, this template helps maintain clear audit trails of who has access to what information, when access was granted, and what consent was provided. The form can feed directly into your CRM, resident management system, or a Google Sheet for tracking and compliance reporting.

Built with flexibility for diverse care settings:

Whether you operate independent living communities, memory care units, or full assisted living facilities, this template adapts to your access policies. Customize access level options, add facility-specific consent requirements, and adjust fields to match your portal's capabilities—all without touching a line of code.

Paperform's SOC 2 Type II compliance and enterprise-grade security make it an ideal choice for healthcare-adjacent workflows where protecting resident information is paramount. Learn more at Paperform Trust Center.

Streamline family engagement, reduce admin time, and provide transparent care communication with a portal access request process that works as smoothly as your care delivery.