This “pre-admission history and physical examination” form is one of the requirements for admission to Westminster Village Muncie, a planned residential community for persons of retirement age.
Westminster Village Muncie is designed for active retirement living and is not a nursing home, although a licensed skilled health care facility is located on the premises. Each resident must be capable of independent living and must ambulatory. A Nursing Evaluation will be administered by our nursing staff prior to Residency, and repeated thereafter on a biannual basis. An annual update of each Resident’s physical examination and testing for Tuberculosis is also a requirement of residency.
Therefore, your assessment of the prospective resident’s capacity to manage on his/her own, especially with reference to ambulation and mental condition, is vital to our determination for or against admission. Please upload a current medication list and a list of immunizations.
We realize that certain limitation may come with age, and that not all impairments necessarily preclude admission. Please feel free to make any additional comments you consider relevant.
Thank you for your cooperation. Please forward test results unavailable at the time of this examination to:
Westminster Village 5801 W. Bethel Ave Muncie, IN 47304/ATT: Admissions Coordinator.