New resident intake

Fill it out once.

Enter your loved one's information one time. We'll pre-fill the move-in forms for your home, ready to print, review, and sign together with David.

Your medical and personal details stay on this device. Everything you type is used only by your own web browser to fill in the forms — your medical information and card photos are never sent over the internet or stored on any server, unless you choose to send them. When you generate your packet, we send a short move-in notice to the APCH team (resident name, the home and its address, the monthly rate, your name, phone & email, and the deposit/move-in dates) so we can confirm your move-in date with you. After generating, you can also choose to send your completed information to David so your packet is printed and waiting when you meet.

Step 1

Which home is your loved one moving into?

Home *

Step 2

Resident & family information

Step 3

Current medications

List each medication your loved one takes regularly, as it appears on the bottle or pharmacy printout. These fill the Routine Medications table on the Admission Orders your physician signs. For tablets and capsules, give the strength of one tablet or capsule and how many make up a dose — for example, a 50 mg dose taken as two 25 mg tablets.

Step 4 · optional

Photos of insurance & ID cards

Snap or upload a clear photo of each card. These print on one sheet you bring with the packet. They never leave your device — nothing is uploaded to us or anyone else.

APCH staff:

Your packet for

Forms marked Pre-filled already include your answers. Open each one, review it, then print and sign. You can still edit any field before printing.

Want it printed and waiting for you?

Send your completed information to David and your packet will be printed before you meet — no need to print at home. This sends everything you entered above, including medications and card photos.