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As the saying goes, "you can't manage what you don't measure." So keeping track of the things we would like to see improved is very important!

The Family Council approved the use of an Event Reporting form. This form should be used to keep records of a problem or concern and how it is addressed by the Facility. Keeping track of to whom you spoke and when, what the response was, and what actions were taken to resolve the problem WILL STRENGTHEN OUR ADVOCACY, both in the Facility and beyond. It will also facilitate conversations and follow-up with staff and administration, and ultimately help drive  collaborative, positive change for our loved ones.

There are several ways to access the forms to provide information. Feel free to use whichever one is the easiest for your situation! The main thing is that you use them--and become part of the solutions!


You can access a version of the form which can be completed on your smartphone, tablet, or computer by clicking here. Simply complete the form and email it to us at

You can access a version of the form to download and print so that you can complete the form by hand. Simply click here for the form.

You can complete the form below directly on this website, and when you hit "submit," it will be sent directly and securely to the Family Council mailbox.

Event Reporting Form

Thank you for helping to make improvements in the quality of live of our loved ones!

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