Documents to be Completed by Family Caregiver/ Residents Prior to Admission

Please note that in order to meet regulatory requirements and to serve you better you are requested to complete/ help complete certain documents that are listed below (please click on the links) before admission to the facility.

Documents needed from the resident’s physician:

  • Physician’s Visit Report and/or a detailed history and physical completed no more than 90-days prior to admission
  • Admission Orders

Please review the Resident Handbook for the facility of your interest: (i) Columbus (ii) Toledo (iii) Ravenna (iv) Maple Heights (v) West Union

Please submit the following completed documents:

Please schedule an appointment with an Alpine House nurse to complete

  • Appraisal/ Health Assessment (within 90 days prior to admission)

*Alpine House facilities do not allow use of marijuana in any form (medical or recreational) on their premises. Smoking is not allowed inside the building. Smoking is only allowed in designated areas located outside the buildings.*