Heritage of Care Website Content Form

Thank you for taking the time to fill out this form. Please enter the location and the contact details for the individual who is submitting this form. Please note, at the bottom of the form there is an “other” box. This box is designed for you to let us know if you offer any of the services below under a different name. (Example: We offer physical therapy under the name of RESTORE)

"*" indicates required fields

Please indicate if your location offers these services and amenities.

Services

Skilled Nursing*
Independent Living*
Assisted Living*
Supportive Living*
Memory Care*
Respite Care*
Day Care*
Hospice Care*
Short-Term Rehab*
Shelter Care*
Medicare Certified*
VA Contracted Facility*
Medicaid*
Do you use the RESTORE Therapy brand?*
Speech Therapy*
Occupational Therapy*
Physical Therapy*
Respiratory Therapy*
Outpatient Therapy*
IV Therapy*
TPN*
Wound Care*
Tracheotomy Care*
Electrical Stimulation*
Vital Stimulation*

Amenities

Hair Salon / Barber Shop*
Memory Support Group*
Walk to Dine*
Community Bingo*
Restorative Program*
Resident Council / Advisory Board*
Family and Community Volunteer Opportunities*
Transportation*
Community Service*
Dentist*
Podiatrist*
Audiologist*
Clinical Psychologist*
Opthamologist*
Who should receive the email for the “contact us” form on the new website? (One person. Please include name and email)