KeepIn Touch Family Contact - Western PA

Choose the Home Your Family Member is in (Drop Down): *

Resident's Name: *

First

Last

In order to maintain confidentiality, please only indicate the FIRST NAME and FIRST INITIAL of the last name. If you would like to send a message to all residents or all staff, please put ALL RESIDENTS or ALL STAFF in the fields above. Thank you.

Relationship/Friendship to Resident:

Message to your loved one:

Pictures or Videos to Share: (<20MB)

Click or drag files to this area to upload. You can upload up to 4 files.

Your Name: *

First

Last

Your Email (if applicable)

QLS Apollo	Count	Test Negative	Test Positive
Skilled Nursing	184	0	0
Personal Care	46	0	0
Staff	148	5	1
Totals	378	5	1

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