First Name* Last Name*
Email Phone Number*
Address City
State Zip/Postal Code
What would you like to do? Schedule a visitRequest more information
What services are you interested in? Check all that apply: Assisted LivingIndependent LivingSkilled NursingMemory CareHospice CareRehab/Therapy
Locations* —Please choose an option—Amherst - Amherst ManorAmherst - 1907 Assisted Living At Central SchoolAvon Lake - Towne Center Community CampusLorain - Anchor LodgeLorain - Autumn AegisMassillon - Rose LaneOlmsted Falls - Village Of The FallsTallmadge - Heather KnollTwinsburg - Grande VillageWellington - Elms Retirement VillageWooster - Smithville WesternBluffton / Okatie - Sprenger Healthcare BlufftonPort Royal - Sprenger Healthcare Port Royal
Who are you considering this facility for? MyselfMy ParentMy SpouseAnother Family Member
What is the potential resident's current living arrangement? Lives in an independent senior living communityLives in an assisted living communityLives in a nursing and rehabilitation facilityLives with a friend or family memberLives at home with some assistanceLives independently at home with no care services
How did you hear about us? Friends or familyProfessional referral (social worker, doctor, etc.)NewspaperInternetOther
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