OSR Care — Pilot

Dovehaven Staff Intake

Please only submit this form if you have consent from the resident or their family/representative.

Time to complete: 5–8 minutes. You will receive the finished song link by email.

Staff details

Your name *

Your work email *

Care home *

Resident basics

Resident first name *

Resident age (if known)

3 words to describe them *

Music — helps us match the genre

Favourite music / bands / artists (or what they enjoyed listening to) *

Memories for the song

What did they love doing? (hobbies, interests, routines) *

A proud moment or something they were known for (optional)

Family names to include (and relationship) (optional)

Anything sensitive to avoid mentioning *

Song settings

Song feel (choose the closest) *

Overall mood *

Consent

Who provided the information? *

I confirm I have consent from the resident or their family/representative to submit these details for the purpose of creating and sharing a keepsake song.

Submissions are sent securely to the OSR Care team at Our Song Request. All details are handled in line with GDPR.