Health History Signature Page

Please download the Health History Form, read through it and sign it.  We will need you to either fax this page into us or mail it to us.

To download the Signing of Health History For Occupancy Form please click here or click on the PDF icon.  This page will either need to be faxed to Port Charles or mailed to Port Charles.  Again this is the signature Page for the Health History Form for Occupancy.