Senior Residence 
Information Upgrade

Your contact information as you would like to have it listed 
(required fields in red):  

Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Phone
FAX
E-mail
URL

Normal office hours and time zone:  

Primary type of facility:  
Continuing care Independent assisted living Life care Alzheimer's/Memory Multi-level care facility Nursing home Headquarters for multiple facilities Home/community based service Choose

Medicare coverage of services:  Yes No Varies

Are pets allowed: N/A Yes No Varies

Emergency contact number: 

In business since:  Year

Business associations and affiliations:

BBB
Chamber of Commerce

Professional affiliations and associations (list one on each line):

We highly recommend that you list your costs as it is a primary consideration to anyone that would consider your facility.  It is not required however.  If your facility does not have an identifiable range (e.g. percentage of income), type the "%" sign in each box.
Highest monthly cost: 

Lowest monthly cost: 

Total number of employees:  Select 1-5 6-10 11-20 21-30 31-50 51-75 76-100 101-150 151-200 201-300 301-500 501+

Total number of units: 

Total number of independent living units: 

Total number of assisted living units: 

Total number of nursing care units: 

Total number of Alzheimer's/memory units: 

Do you do criminal records checks on employees:  N/A Yes No

Do you do employment background checks on employees?  N/A Yes No

Do you drug screen your employees?  N/A Yes No

Is your facility on a bus line?  N/A Yes No

Images that will be provided by you for your page:

None
Logo
Sample image 1
Sample image 2

Please input your text that will be used in the body of your page (optional).  Please note that SeniorMag will not edit your text.  It should conform to our merchant rules of conduct.  You are responsible for spell-check, grammar, and punctuation.  No HTML tags are allowed.  SeniorMag reserves the right to format the text according to our site format requirements:

Up to 2000 characters allowed including spaces. Delete this text and insert your own profile text. We recommend that you use this space to describe your business or services to your client. Important tip: Do not include text such as your company name or other information found in other fields on this page. That information is available in addition to this text. Use this space wisely to talk directly to your prospective client.

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