Visit us: Mon - Fri: 9:00 - 18:30
Braley Care Homes 6192 US 60 Hurricane, WV 25526
Resident
Application Form
Resident
Application Form
General Information
History
Present Physicians
Medical Information
Present Physical Condition
Psychological Information
Other Information
Each resident shall have a written, signed and dated health assessment by a physician or other licensed health care professional, authorized under the state law to perform this assessment, not more then sixty (60) days prior to the residents admission, or no more than five (5) working days following admission, and at least annually after that. The admission and annual health assessment shall include screening for tuberculosis and other communicable diseases if indicated by exposure, prevalence or risk according to current medial practice in congregate living situations as indicated by the secretary.
Responsible Parties To Be Notified In Case Of Emergency, Discharge Or Demise Of The Resident:
Check If Applicant Has Any Of The Following:
Insurance Information
* Please note that Braley Care Homes will ask for copies of the applicant's insurance cards, Social Security card, MPOA, POA, Living Will and DNR (if applicable).
KEEP IN TOUCH.
CONTACT US
Location:
Braley Care Homes
6192 US 60
Hurricane, WV 25526
Phone Numbers:
Referrals and Inquiries: (304) 767-4033
Facility Phone: (304) 201-3677
Facility Fax: (304) 201-3678
AREAS WE SERVE
BUSINESS HOURS
Monday
9:00am – 6:30pm
Tuesday
9:00am – 6:30pm
Wednesday
9:00am – 6:30pm
Thursday
9:00am – 6:30pm
Friday
9:00am – 6:30pm
General Information
History
Present Physicians
Medical Information
Present Physical Condition
Psychological Information
Other Information
Each resident shall have a written, signed and dated health assessment by a physician or other licensed health care professional, authorized under the state law to perform this assessment, not more then sixty (60) days prior to the residents admission, or no more than five (5) working days following admission, and at least annually after that. The admission and annual health assessment shall include screening for tuberculosis and other communicable diseases if indicated by exposure, prevalence or risk according to current medial practice in congregate living situations as indicated by the secretary.
Responsible Parties To Be Notified In Case Of Emergency, Discharge Or Demise Of The Resident:
Check If Applicant Has Any Of The Following:
Insurance Information
* Please note that Braley Care Homes will ask for copies of the applicant's insurance cards, Social Security card, MPOA, POA, Living Will and DNR (if applicable).
Our clinic largest private mental health partnership, with a carefully selected nationwide team of Psychiatrists.
KEEP IN TOUCH.
CONTACT US
Location:
Braley Care Homes
6192 US 60
Hurricane, WV 25526
Phone Numbers:
Referrals and Inquiries: (304) 767-4033
Facility Phone: (304) 201-3677
Facility Fax: (304) 201-3678
AREAS WE SERVE
BUSINESS HOURS
Monday
9:00am – 6:30pm
Tuesday
9:00am – 6:30pm
Wednesday
9:00am – 6:30pm
Thursday
9:00am – 6:30pm
Friday
9:00am – 6:30pm