Admission / Intake Question Wording

Use this wording at admission. Make every question voluntary, offer a "prefer not to say" option, and explain where the answer goes. Never ask in a shared space or within earshot of others.

Opening

"So we can care for you in the way that fits you best, may I ask a few questions about your identity and who matters to you? You do not have to answer any of them, and anything you share stays private — only the people caring for you will see it, and you can change it anytime."

Name and pronouns

"What name would you like us to use? What pronouns? (e.g. she/her, he/him, they/them, or something else.) Is the name on your health card different from the name you use?"

Gender identity

"How do you describe your gender? (e.g. woman, man, non-binary, Two-Spirit, or your own words.) You can say ‘prefer not to say.’"

Who matters to you

"Who should we call and welcome as your family — partner, chosen family, friends, or others? Who do you want involved in your care decisions?"

Personal care preferences

"For personal care, do you have a preference about who provides it — for example, a woman or a man? Is there anything about your body or personal items we should know to care for you comfortably?"

Privacy rule to state out loud

"This goes in your care plan. It is not shared with other residents or visitors, and only the staff who need it to care for you will see it."