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

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

Contact Us

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 Oaklawn.

*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:
Insurer Name:
Insurance Number:
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.

Short-Term Rehabilitation
| Long-Term Care | Medical Care
Private Rooms | Hotel Atmosphere | Dining | Photo Gallery | Job Openings
Medicare | Directions | Contact Us | Site Map
©2008 Senior Care, Inc.