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Contact Us
5595 SW West Hills Rd.
Corvallis, OR 97333
Ph: 541-753-7136
Fax: 541-257-2008
administratorWH@bonaventuresenior.com
Contact Information
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Name:
Relation to Resident:
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Address:
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City:
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State:
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Zip Code:
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Home Phone:
Work Phone:
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E-Mail Address:
Other Contacts:
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Prospective Resident Information
Name:
Address:
City:
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Zip Code:
Home Phone:
Age:
Marital Status:
single
married
Gender:
male
female
Second Occupant Info:
Any special problems/needs for the resident or family?
Apartment Preference
Type of Housing:
Retirement
Assisted Living
Memory Care
Apartment Preference:
Studio
1 Bedroom
2 Bedroom
Memory Care-Private Apt
Memory Care Semi-Private
Payor Type:
Private Pay
Medicaid
Long Term Care Insurance
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Additional Comments:
Bonaventure Senior Living. Copyright 2010. All Rights Reserved
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