---
title: "ADL checklist: free printable ADL and IADL list"
description: "Check your parent's 6 ADLs and 7 IADLs in two minutes, see which tasks need help, and print the summary for the doctor or an agency."
url: https://seniorchoicecare.com/assess/adl-checklist/
updated: 2026-10-10
site: Senior Choice Care
---

Printable tool

# ADL and IADL checklist

Thirteen everyday tasks. Pick what your parent can do this week, see a summary of what needs help, and print it.

**5 minute read** Updated October 9, 2026Written by the Senior Choice Care team

In short

An ADL checklist records whether your parent can do each basic self-care task, such as bathing, dressing and eating, plus household tasks like meals, money and medicines, alone or with help. Use the checklist below, then print the list of tasks that need help to share with the doctor, a care manager or a home care agency.

**Written by the Senior Choice Care team** Updated October 9, 2026. Facts are checked against the sources listed at the end of this page. General information; every family is different.

Printable checklist

### ADL and IADL checklist

Go through each task as things are this week. Pick what your parent can do without help. Then print the list for the doctor, a care manager or an agency. Nothing you choose leaves this page.

An original checklist of the everyday tasks care teams commonly review. It is not the Katz Index, the Lawton scale or any other validated instrument, and it is not a diagnosis.

## How to use the result

- **Repeat it** every few months, and after any fall or hospital stay
- **Bring it** to the doctor or to an assessment
- **Be specific**: note what kind of help, how often, and at what time of day

## Questions families ask

### What is an ADL checklist?

A list of daily tasks used to record which ones a person can do alone.

### Is this the Katz Index?

No. It is an original checklist for families. The Katz Index is a clinical tool.

### Can I print the results?

Yes. Use the print button after answering.

### Do my answers get saved?

No. Nothing leaves your browser.

## Sources

- [Hartford Institute for Geriatric Nursing: Katz Index of Independence in ADLs](https://hign.org/consultgeri/try-this-series/katz-index-independence-activities-daily-living-adl)
- [National Institute on Aging: What is long-term care?](https://www.nia.nih.gov/health/long-term-care/what-long-term-care)
- [National Institute on Aging: Services for older adults living at home](https://www.nia.nih.gov/health/caregiving/services-older-adults-living-home)

## Read next

- [ADLs](https://seniorchoicecare.com/assess/activities-of-daily-living/)
- [IADLs](https://seniorchoicecare.com/assess/iadls/)
- [Care-level matcher](https://seniorchoicecare.com/assess/care-level-matcher/)
- [Katz index](https://seniorchoicecare.com/assess/katz-index/)

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