Flagstaff
Care
Homes.com
Senior Assisted Living Homes in Flagstaff, Arizona
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Medicaid
Residents
Accepted
Home
The Pines
Pine Meadows Ranch
Specialized Care
Provided Services
Activities
About Us
Contact Info & Maps
Senior Resources
Family Resources
Links
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Forms Needed For Resident Check In
Please be aware that all of these forms need to be completed in accordance
with the Arizona Department of Health rules and regulations
Each home has seperate documents, so please select accordingly
The Pines
Pine Meadows Ranch
Documents are in PDF format
All Physician Documents (212 kb)
All Resident Documents (369 kb)
Individual Physician Documents
Consent For Medication Administration (11 kb)
Physician's Report (33 kb)
Physician's Routine Orders (11 kb)
Tuberculosis Test Results (87 kb)
Individual Resident Documents
Acknowledgement (11 kb)
Admission Agreement (11 kb)
Evacuation Plan (15 kb)
Food Preference Questionnaire (10 kb)
Grievence Procedures (10 kb)
Home Rules (11 kb)
Important Phone Numbers (15 kb)
Insurance Card (8 kb)
Living Will (15 kb)
Residency Agreement (29 kb)
Resident Information (12 kb)
Resident Inventory (62 kb)
Resident Rights (17 kb)
Resident Situation & Health (70 kb)
Resident Social & Recreational Activities (11 kb)
Vacination Authorization (58 kb)
Welcome Letter (29 kb)
Documents are in PDF format
All Physician Documents (212 kb)
All Resident Documents (369 kb)
Individual Physician Documents
Consent For Medication Administration (11 kb)
Physician's Report (33 kb)
Physician's Routine Orders (11 kb)
Tuberculosis Test Results (87 kb)
Individual Resident Documents
Acknowledgement (11 kb)
Admission Agreement (11 kb)
Evacuation Plan (15 kb)
Food Preference Questionnaire (10 kb)
Grievence Procedures (10 kb)
Home Rules (11 kb)
Important Phone Numbers (15 kb)
Insurance Card (8 kb)
Living Will (15 kb)
Residency Agreement (29 kb)
Resident Information (12 kb)
Resident Inventory (62 kb)
Resident Rights (17 kb)
Resident Situation & Health (70 kb)
Resident Social & Recreational Activities (11 kb)
Vacination Authorization (58 kb)
Welcome Letter (29 kb)
You may also have these documents emailed, or faxed to you
For a tour of our homes please call 928-635-6750