Nori
Senior intake form
Collect senior and family contact details for daily check-in calls.
Senior details
Full name
*
Age
*
Phone number
*
E.164 format — include + and country code
Preferred call time
*
Their local time
Timezone
*
Eastern (ET)
Central (CT)
Mountain (MT)
Pacific (PT)
Arizona (no DST)
Hawaii (HT)
Alaska (AKT)
Contact mode
Phone call
Text message
Health and preferences
Health notes
Conditions, medications, or physical limitations Nori should know
Interests and preferences
Hobbies and favourite topics
Family contact
Contact name
*
Relationship
Daughter
Son
Spouse
Sibling
Friend
Caregiver
Other
Family phone for SMS alerts
*
Receives concern alerts and missed call notifications
Settings
Persona type
Senior
Adult
Teen
Active
Yes — start calling
No — paused
Consent
I consent to Nori recording and analyzing conversations with the senior for the purpose of wellness monitoring and family alerts. Recordings are used only for this purpose and are not shared with third parties.
*
Required to use Nori
Add senior to Nori