a logo for rochester presbyterian home with a heart and arrows

    Admissions Application

    Admissions Application

    When considering admission to a Rochester Presbyterian Home community, individuals or their representatives are asked to complete the application below. This application designed to obtain crucial information about the prospective resident. This will help us to evaluate their specific needs comprehensively and provide the appropriate care and support they deserve.

    Please download and complete the application below.
    Download Admissions Application

    Please email the completed application to admissions@rph.org. You can also drop off your application in person, mail it to 256 Thurston Road, Rochester, NY 14619, or fax it to 235-1315.
    Share by: