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These are forms that long-term care facilities would
need to fill out and submit prior to admission to the Pine Rest Dementia
Living Center.
Please Note
An initial phone screen must be conducted prior to filling
out the paperwork– at 616/222-4515.
The following forms are in Microsoft Word format.
Admission Process
Checklist
Consent for Treatment
Release of Information
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Contact Information:
For more information, contact:
Lois McGinniss
Administrative Secretary
Center for Senior Care
616-222-4550
lois.mcginniss@pinerest.org
Suzann Ogland-Hand, PhD
Director, Center for Senior Care, & Geropsychologist
616-222-4550
suzann.ogland-hand@pinerest.org
Dementia Living Center staff
Kim Curyto, PhD
Clinical Director &
Research Scientist
616-281-6363, x2021
kimberly.curyto@pinerest.org
Katie Corbett, BSW
Supervisor
616-281-6363, x2088
kathryn.corbett@pinerest.org
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