Contact Us

Welcome
Short-Term Rehab
Pre-Registration
Long-Term Care
Medical Care
Private Rooms
Hotel Atmosphere
Dining
Photo Gallery
Home

Home > Short-Term Rehab > Pre-Registration > Pre-Reg Form

300 Shelby Station Dr • Louisville, Kentucky • 40245 • 502.254.0009

Pre-Registration Contact

Please fill out this form and submit it to us so that we can contact you
about reserving your private room at the Oak Club at Oaklawn.

Amanda Sheilds
Director of Admissions

*Name:
Address:
*E-Mail:
*Daytime Phone:
Evening Phone:
Best time to call:
*Hospital or Surgical Facility:
*Type of surgery:
*Primary care physician:
Surgeon:
*Date of surgery:
*Date of arrival at Oaklawn:
Message or other information:

PLEASE NOTE: Submission of this form initiates, but does not complete, the pre-registration process. We will call you to schedule a lunch, tour and meeting to complete the pre-registration process in order to guarantee your private room.

Medicare | Directions | Contact Us | Site Map