SilverStay Assisted Living referral
Thank you for partnering with SilverStay. After submitting data on this form, SilverStay will immediately begin processing the referral, collecting more information from family if needed, and sharing de-identified information with Assisted Living communities to identify potential matches. We will provide you with updates via email using the designated patient ID.
Please note that privacy and encryption settings enforced by SilverStay ensure that information provided in this form remains private. We do NOT collect full patient names, dob, or other protected health information (PHI) through this form. Additionally we only share de-identified information with assisted living communities and NEVER share information that is indicated below as "(Private)."