Dear Applicant:

Thank you for your interest in Schuyler Ridge Adult Day Health Care Program. Our Adult Medical Model Day program is an integral part of a growing health care system in our community.

As part of the application process you will find enclosed the following forms.

• Participant Information Sheet
• Release of Information
• Regulations for the Adult Day Program
• Physician's Report Form
• Physician's Orders
• Admission Agreement

Please review this information taking note that a Physical Exam within 6 weeks as well as a TB test within one year is mandatory prior to your admission to the program.

After receipt of the release of information, we will contact your physician for necessary medical reports and orders to assist us in your care at Schuyler Ridge.

We look forward to working with you. If you have any questions about the program, please feel free to contact us at any time.

Sincerely,

Sharon Gliosca, RN
Manager, Adult Day Care

SG/dta
Enclosures