The Brook Retirement Communities

Independent Living and Assisted Living

CORPORATE OFFICES

PHONE (989) 745-6500

FAX (989) 745-6505

PHYSICAL ADDRESS 203 Meadows Dr, Grayling, MI 49738

MAILING ADDRESS PO Box 649, Grayling, MI 49738

BUSINESS HOURS Monday – Friday 8:00am – 5:00pm

INQUIRY

Have a question or comment? Please fill out our form and we will promptly reply back to you within 24 business hours or sooner.

Contact Brook Retirement

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APPLICATION FOR ADMISSION

Are you ready to join the Brook Family? Fill out our application for admission to get the process started. If you have any questions, or need help with the form, please call us at (989) 745-6500

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Application For Admission

Date *

PERSONAL INFORMATION

Full Name *

Date Of Birth *

Street Address *

City *

State *

Zipcode *

Phone *

Are You Currently in an Independent / Assisted Living Facility? *

If YES, Please List Name and Address of Facility

PERSONAL PHYSICIAN / PROVIDER

Name of Physician

Physician Specialty or Type

Phone

Street Address

City

State

Zipcode

PERSONAL PHYSICIAN / PROVIDER 2

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Physician Specialty or Type

Phone

Street Address

City

State

Zipcode

RELATIVES: (Spouse first, if applicable, then children and other relatives)

Full Name (Relative 1)

Relationship

Age

Street Address

City

State

Zipcode

Phone (Home or Mobile)

Phone (Work)

Full Name (Relative 2)

Relationship

Age

Street Address

City

State

Zipcode

Phone (Home or Mobile)

Phone (Work)

Full Name (Relative 3)

Relationship

Age

Street Address

City

State

Zipcode

Phone (Home or Mobile)

Phone (Work)

Full Name (Relative 4)

Relationship

Age

Street Address

City

State

Zipcode

Phone (Home or Mobile)

Phone (Work)

POWER OF ATTORNEY / WILL INFORMATION

Do You Have an Power of Attorney or Guardian? *

If YES, Please list Name, Address and Phone Number

Do You Have a Living Will? *

BILLING INFORMATION

Please Bill Me

AT MY BROOK ADDRESS

PLEASE SEND BILL TO ANOTHER ADDRESS

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Our purpose is clear.
Our performance is consistent.
Our passion is people.

Our purpose is clear.
Our performance is consistent.
Our passion is people.

LIVING AT THE BROOK

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ABOUT US

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TERMS AND CONDITIONS

The Brook Retirement Communities

CORPORATE OFFICES

INQUIRY

APPLICATION FOR ADMISSION

LIVING AT THE BROOK

RESOURCES

CORPORATE

FOLLOW US

LIVING AT THE BROOK

RESOURCES

CORPORATE

FOLLOW US