Luxor Nursing & Rehab Communication Request Form
Dear Family & Friends, welcome to our online Communication Request Form.

In light of recent events as a result of the COVID pandemic, we know that communication with the facility, our Social Workers and most importantly, your loved ones, is more important than ever. Furthermore, not being able to visit your loved one only adds to that need. As a result, our call lines have been unusually busy and our staff have been working tirelessly to stay in touch with you, our family members.

To that end, we offer this online form as an added way for you to reach out and make requests.
Please feel free to complete the form below, once submitted we will reach out to you as soon as we can, stay well and thank you for bearing with us during these trying times.

Sincerely,

Your Luxor Family
Your Name *
Your answer
Best number to reach you: *
Your answer
What is the name of your loved one? *
Your answer
What is the Room Number of your loved one?
Your answer
What is your Request *
Submit
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