Senior Living Resident Weight Monitoring Log Form
Log and track resident weight trends to support health monitoring in a senior living environment.
Resident Full Name
*
First Name
Last Name
Date of Weighing
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Weight (lbs)
*
Time of Day
Hour Minutes
AM
PM
AM/PM Option
Staff Member Recording Entry
*
First Name
Last Name
Observed Changes Since Last Weighing
Appetite/Fluid Intake Observations
Notes or Concerns
Submit Log Entry
Should be Empty: