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If you would like information about admitting a resident to one of the Concord Care Centers, contact us! You can reach us any time of day or night by calling our Facilities. Telephone numbers are provided on the "Locations" page. If you prefer, admission information can be obtained by completing the Placement Inquiry form below, and forwarding it to us as indicated at the bottom of the form. We are also available by e-mail at "info@concordcarecenters.com." We will respond to your electronic inquiry the next business day.



PLACEMENT INQUIRY

NAME DATE:
ADDRESS
CITY, STATE, ZIP
TELEPHONE
E-mail


FACILITY DESIRED (check one):
Cortland  Hartford   Sandusky  Toledo

RESIDENT INFORMATION
AGE OF RESIDENT   MALE    FEMALE

RESIDENT WILL BE ADMITTED FROM:

Home    Hospital    Other

PRIMARY PAYMENT SOURCE:

Private Pay    Medicare    Medicaid
Private Insurance    Other

SPECIFIC QUESTIONS OR COMMENTS

  

Concord Care Centers