Long Term Care Contact Form

Contact our Long Term Care Team
Please fill out the form below if you'd like one of our representatives to contact you about our services. The information you provide here is only used by Rochester Regional Health. If you have questions, please feel free to contact us at (585) 368-6565.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Who are you inquiring for?*
How did you find us?*
Please indicate the services you are interested in.*

Skilled NursingLong Term CareDementia/Memory CareRehabilitation CareVentilator CareNeuro-Behavioral CareUnsureOther
Please indicate the long term care communities you are interested in.*

Park Ridge Living Center (Wegmans Family Cottages)Park Ridge Living Center (McCormick Transitional Care Center)Edna Tina Wilson Living CenterDeMay Living CenterUnity Living CenterClifton Springs Nursing HomeUnsure
What payment options are you interested in exploring for care?

MedicareMedicaidCommercial insurancePrivate payUnsureOther
Questions and Comments:
I am interested in receiving "Your Guide to Skilled Nursing".
How did you find us?
Questions/Comments (old)
Please indicate the skilled nursing facility location you are interested in:*
Should be Empty:

Contact our Long Term Care Team