In addition to this form, please fax current history and physical, medication list, and the last two weeks of nursing notes. Thank you for your referral. We will review the information and contact you within 1 business day.
Any additional questions please contact:
Choose A Place You Can Call Home
2221 North Arlington Avenue Duluth, MN 55811
Phone: (218) 722-1501 Fax: (218) 722-5882
Mon - Sun 24/7