Pre-Admission Form



Please provide the following information and hit the 'submit' button. If you have any questions or need any assistance, please call our admission staff at 813-261-5500.

  • Demographic Information

  • Date Format: MM slash DD slash YYYY
  • Financial Information

  • Reason for Skilled Nursing Center Placement

  • Date Format: MM slash DD slash YYYY
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  • Contact Information

  • Demographic Information

  • Date Format: MM slash DD slash YYYY
  • Financial Information

  • Reason for Skilled Nursing Center Placement

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Contact Information

REVIEWS

Jacksonville Nursing & Rehab, took very good care of my loved one. Not only was the nursing staff always kind and courteous, they showed respect and were highly skilled. I visited twice a day while my grandmother was there and never had any issues with cleanliness. Staff was always in the halls mopping or buffing the floors. We did have one mechanical issue, her bed was not working properly however maintenance visited the same day and was able to fix the problem in no time. The main reason of her stay was rehabilitation, and the rehab department did just that! They work diligently to ensure my grandmother could preform daily routines once she went home. I would highly recommend them to anyone. On a side note... the food is the same as most hospital and facilities, however I do give them props for being creative on flavors and not having the same thing twice during her stay! Definitely consider if needed!
Ian Broome
google
I cannot speak highly enough about the care provided at this center! The staff is so attentive, the facility is very clean, and the food is delicious. I would recommend this center to anyone in need of short-term rehab or long-term care!
Stacy Wilson
google

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