Startthe admissions process

If you're being discharged from a hospital, short-stay rehabilitation can help "bridge the gap" between hospital and home-and give you the extra time you need to get back on your feet again.

Orchard Park Health and Rehabilitation Center offers a complete range of transitional and post-surgical care services.

 

1. First, some information about the person filling out this form.

Your Name:

Your phone number: - -

Best time to reach you:

The person you are referring is:

Myself

My parent

My child

My patient

Other:

2. Please tell us about the person you are referring.

Name:

Gender: Male

Female

Age:

Reason for considering admission to our Center:

Long-term Care

Short-term/Subacute Rehabilitation

Respite Care

Hospice Care

Any special needs we should consider?


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