"Come to me all who are weary and burdened, and I will give you rest" - Matthew 11:28

Resident Application Form

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Step 1 of 2

Application

Parkview Village is Not-For-Profit facility that opened in early 2009. It is an unlicensed health care facility, registered with the Indiana Division of Housing and Social Living. This application is for the purpose of being placed on a waiting list for either Independent Apartment Living with Catered Services or Independent Duplex Living. Parkview Village will provide staffing around the clock, 3 meals a day and assistance with housekeeping, laundry, and limited assistance in activities of daily living.
We will emphasize assistance, and support independence and promote dignity for each resident
Parkview Village is located at 800 S. West St., Odon, IN, 47562. A fee of $400 is due with this application. Upon admission, the fee is used as a security deposit for repairs. This fee will be refunded should you unable to move in. For more information, contact us at (812) 636-3000.
Civil Status
Gender
MM slash DD slash YYYY
I wish to be placed on the waiting list for
I wish to be placed on the waiting list for
Are you currently living alone and taking care of your own personal needs?
If the above answer is no, in what areas are you needling assistance? (Check all that apply)
Have you ever pleaded guilty, no contest or been convicted of a crime?
Please return application and $400.00 deposit to 800 S. West St., Odon, IN 47562
MM slash DD slash YYYY

Schedule Appointment

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