Getting Started

Please leave us some preliminary information, especially the required fields so we can begin to help you identlfy the right care facility for you or your loved one. We will contact you quickly to start the process.

Preliminary Client Information
Personal:
* Client's Name:    
Client's Location: Client Phone:
* Client's Age: Gender(M or F):
Referred By: Phone:
 
Medical Conditions and Care Needs:
Explain:
Special Circumstances:
Dementia: Hospice:
Insulin Dependent: Incontinent:
Oxygen: Other:
    Explain:
 
Responsible Party:
* Name: * Phone:
Address: * Email:
Relationship: Fax:    
 
Preferences:
* When is placement desired?:
* Financial Range for Monthly Care:
Facility Preference:

* required fields
 

 

Contact:

Phone: 707-570-0257
Fax: 707-578-2379
131A Stony Circle,
Suite 500
Santa Rosa, CA 95401
General Information:
options@sonic.net

Call Placement Options today for a complimentary assessment!

Please note that Placement Options is reimbursed by the facilities they contract with. Therefore, most services are offered to our clients on a complimentary basis.