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Application for Prospective Friedman Place Resident
5527 N. Maplewood, Chicago, IL, 60625. Telephone: 773.989.9800 Website:
www.friedmanplace.org
Please note that Friedman Place typically has a waiting list and gives priority to residents of Illinois.
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NAME:
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Friedman Place provides assistance nearly at the level of an assisted living program and is not a nursing home. Do you feel that is an appropriate level of care and assistance to meet your needs?
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Address (City and State) - Please note that priority is given to Illinois residents and we typically have a waiting list:
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What type of residence are you living in now?
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