SEM Haven - Admissions

SEM Haven Health & Residential Care Center • 225 Cleveland Ave. • Milford Ohio 45150 • Phone 513-248-1270 • FAX 513-248-0201


The person you are inquiring for is your:	(mother, grandfather, aunt, etc.)

He/she currently resides at:	(home, hospital, retirement community, etc.)

He/she may need:	Assisted Living Short-term Rehabilitation Nursing Care Alzheimer's/Memory Care

Interested in residency:	(when / time frame)

Services and Personal Care he/she may need help with:	Dressing Bathing Grooming Toileting Eating Walking/transferring (describe)

Are you interested in our facility room & board rates?	Yes No
SEM Haven Health Care Center is licensed for both Medicare & Medicaid.
Medicare eligible?	Yes No
Medicaid eligible?	Yes No
Do you have any specific questions you would like to ask?
Would you like any particular information sent?

Your Name:
Phone Numbers:
Street Address:	City: State: Zip:
Email: