Free Listing information is preferred by Email

Reguests are also accepted by Fax or Mail. Please include the following information.

*

Is the business: [___] Lic. by CA DHS *****[___] Lic. by CA DPSS

[___] JCAHO Accredited***** [___] Non-Profit *****[___] Member Contracted Org.

Business/Service: _______________________________________________________

Contact: _____________________________ Position: __________________________

Address: _______________________________________________________________

Phone: __________________________ Fax: __________________________________

Email: __________________________________________________________________

Section of DP Requested: _________________________________________________

Services Provided: _______________________________________________________

________________________________________________________________________

Cost: ________________ Days & Time, if Applicable: ____________________________

*

*Free Listings are a courtesy and are not quaranteed. Free Listings are generally provided for:

a. Facilities/Agencies, Licensed by Dept. of Social Services including RCFEs and Adult Day Care

b. Facilities/Agencies, Licensed by Dept. of Health Services including Hospitals, SNFs and Home Health Care Agencies.

c. JCAHO Accredited Health Care Business.

d. Government and Charitable Programs and Services including Community Services that provide free or low cost services to the public (such as support groups, counseling, flu shots), non-profit business if they are related to the services we list and generally provide assistance on a sliding scale or at low cost.

e. Members of a Contracted Association or Organization.

E-mail: KarmaShelly@DischargePlanner.net

Office: 951.571.7780*****Fax: 951.571.7784

The Discharge Planner, Inc.

23640 Tower St. Suite 1, Moreno Valley, CA 92553