Pre-Admission Form



Please provide the following information and hit the 'submit' button. If you have any questions or need any assistance, please call our admission staff at 813-261-5500.

  • Demographic Information

  • Date Format: MM slash DD slash YYYY
  • Financial Information

  • Reason for Skilled Nursing Center Placement

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Contact Information

  • Demographic Information

  • Date Format: MM slash DD slash YYYY
  • Financial Information

  • Reason for Skilled Nursing Center Placement

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Contact Information

REVIEWS

My 82 year old mother broke 6 ribs and hurt her back when she fell. She had wonderful care at Boynton Beach Rehab. The rehab staff were amazing - they were able to get her walking again. She received excellent care- all of the staff and Administrator are so friendly and kind. She also loved the food and enjoyed the beauty parlor. She went home and is doing so well now. Thank you Boynton Beach for helping my mother through a tough time.
Michelle Kelly
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I would like to thank Boyton Beach Rehab Center for all of their services. Specially the head of each department- Jacque Labitsiere (dietary), Allison Herman (therapy), Nikki Amo (administration), Sheldon Lowan (nursing) and all of their team members. I give this place an excellent rating. I am proud of having been a patient of this place.
Fabio Alarcon
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