Pre-Admission Checklist

The following information will be utilized to process your
application for admission.

If you have any questions, please do not hesitate to contact us.

1. APPLICATION FOR ADMISSION

2. MEDICAL EVALUATION FORM WITH MANTOUX TEST RESULTS FROM DOCTOR

3. LIVING WILL (we will make copies)

4. POWER OF ATTORNEY (we will make copies)

5. MEDICARE CARD

6. PACE CARD

7. HEALTH CARDS (Blue Cross - Blue Shield, Security Blue, UMWA, Railroad, Steelworkers, any other medical cards you may have.)

8. PHARMACY (May continue with existing Pharmacy if they deliver to The Atrium or may use from in-house Martella's Pharmacy - which delivers daily to the facility.)

9. CLOTHING (The resident should be accompanied with approximately seven changes of clothing, shoes, socks and slippers should also be available for the resident's use. All items must be clearly marked with the resident's room number.)