VillageCare at 46 & Ten Admissions Application
To become a part of our wonderful community, please fill out all of the necessary forms below.
Thank you for your interest in VillageCare at 46 and Ten. As a licensed assisted living program (ALP), we provide a safe environment for residents who require assistance with the activities of daily living (i.e. bathing, dressing, toileting, etc.) but wish to maintain their independence.
Below is our admission package, along with supporting documents:
- Admissions Cover Letter
- Application for Apartment G-3
- Application Assisted Living Questionnaire
- ALP Medical Evaluation
- Mental Health Evaluation
- TB Screening
- Diet Orders
- Application Checklist
- FAQs
Please submit the required documents to Rosa Ortega, by mail at 510 West 46th Street, New York, NY 10036. You may also email at [email protected], or you may call 212-337-5600, ext. 6238, if you require additional information.
Your doctor must complete every section of the Medical Evaluation form and provide a clear description of the assistance you will need with activities of daily living, such as; transferring, toileting, dressing, grooming, housekeeping, incontinence care and medication management. Your doctor must print his/her name, address, license number, and telephone number on the medical evaluation form.
After your completed application has been submitted, the Admissions Coordinator will
review the application and, if appropriate schedule an interview. All attached documents must be completed prior to admission. The application and financial questionnaire must be submitted in order to be considered for admission.