Address:
611 NE Ashbury Blvd
Burleson, TX 76028

Phone: 817-447-4477

HERE'S HOW TO CONTACT US:
First Name:
Last Name:
Phone:	( )  -  ext.
E-mail:
Preferred Method of Contact:	E-mail   Phone
Preferred Time:	-- Anytime ASAP Morning Afternoon Evening
Street Address:
City:
State:
Zip:

 

	ANTICIPATED MOVE DATE:
	Month ----- January February March April May June July August September October November December / Day --- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / Year ---- 2005 2006 2007 2008 2009

	I am looking for housing/care for:* Select Relationship --- Parent Spouse Grandparent Self Friend Other Type of Senior Living desired:* Independent Living
	I am interested in:   Unfurnished Furnished     Any Bedroom Studio 1 Bedroom 2 Bedroom 3 Bedroom      Any Bath 1 Bath 1.5 Bath 2 Bath
	Payment Options:  Private Funds Long Term Care Insurance Veterans Assistance Medicare Medicaid Government Subsidy Other
	Current Living Arrangement:  Own Home Rent Home Senior Community Family Members Hospital or Nursing/Rehab Other

 

	I WOULD LIKE MORE INFORMATION ABOUT:
	(i.e. pet policy, availability, etc.)