Questionnaire For HSCL Wait-List
Please complete form to submit to wait list committee. You will be notified after review process.
Name of Perspective Resident
Contact Phone Number
How did you hear about us
Current Cedar Sinai Park Resident
Jewish Community Member
If other please explain
Desired Move-In Time
6 Months to 1 Year
1 Year to 2 Years
What is the age of the perspective resident?
Describe Care Needs
Upon admission to Harold Schnitzer Center for Living, which payer type can you anticipate?
Long Term Care insurance
Describe Cedar Sinai Park Involvement, if any
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