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

First and foremost, I am a healthcare professional in Palm Beach County. I had many good choices and no shortage of contacts when the time came to find quality rehabilitation services for my mother following her serious car accident. Ultimately, I chose Medicana. I can thankfully say that I have zero regrets. Vicky in admissions, Beth in social work, Peta the unit manager, an Nick the rehab manager were all magnificent and provided my mother the care she needed to regain her health and ultimately transition home safely. Many facilities in PBC boasts about their "looks." Medicana may not have the newest and glitziest facility, but their care is second to none. Thank you Medicana for the excellent care you provided my mom!
Nick Matzirakis
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I have been a resident at Medicana for about 3 years. While I have been here, the therapy and activities have been excellent. The food has been pretty good and the nursing staff are very good. The cleanliness and upkeep of the building are excellent. I enjoy being involved as resident council president.
Susan Hyatt
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