Admissions Application

Note: This application does not constitute an admission agreement. Information submitted will be reviewed by Bethany Life staff to determine if further admission procedures are advisable. No obligation is placed on either the applicant or Bethany Life via submission of this application. The offer is accepted when the applicant named above enters Bethany Life as a resident or a tenant, and it becomes part of the overall agreement between the applicant above and Bethany Life. If the applicant makes no other arrangements, and/or no longer desires residency within Bethany Life, this offer should be withdrawn by notice to Bethany Life. When such notice is received, this
admission application will be removed from the file.

Bethany Life shall not deny admission to any resident solely based on the person’s financial inability to pay the full cost of their care. Benevolent support may be available for some residents who are not able to pay the full cost of their care. Application for such support may be made through the business office.