(2) The PHYSICIANS ASSESSMENT FORM may be printed using the above link. The physician’s assessment form is good for 30 days. Services for your loved one must begin within 30 days of the date the form is signed by the examining doctor.
(3) Finally, a TB test or chest x-ray is needed for your loved one as well. We need documentation that he/she is free from tuberculosis before he/she can begin receiving services at the Center. This section is on page 4 of the physician’s assessment form. Please return these forms to us as well.
There is also a Meal Benefit Application (instructions and Benefit form) that we can provide at a later date.
If you have any questions, feel free to contact us. We look forward to serving you.