Request a Tour
Potential Resident Information
First Name
Last Name
Primary Phone
Can a confidential message be left at this number?
Yes
No
Secondary Phone
Can a confidential message be left at this number?
Yes
No
Email
Primary Contact
First Name
Last Name
Relationship to applicant
Son/Daughter
Spouse
Grandchild
Other
Phone
Email
Communicate with
Potential resident
Primary contact
Eligibility
I understand that the potential resident must be able to move independently from their suite to the the dining room three times per day.
I understand that the potential resident must be able to manage their own medications.
I understand that the potential resident must be able to manage their own care, including but not limited to, doctor's appointments and visiting health care providers.
I understand that the OSCR Tower is not a secure facility and that residents may come and go as they please.
Consent
By clicking "Submit", you agree to send this personal information to Oakville Senior Citizens Residence online. You agree to these
Terms and Conditions
and
Privacy Policy
, which govern how your personal information is kept safe.
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