Applications

Below you will find all the documents required to apply for residence at the Vibrant Aging Community Center. Please print and fill out the forms and email them to Dr. Esi Colecraft email: vaccenter@vibrantagingcc.com 

APPLICATION PROCESS CHECKLIST
1. Read VACC Policy Document
2. Fill out pre-screening forms (4)
3. Submit pre-screening forms ( in person or via email) and await notification of eligibility status
4. If you pass the pre-screen process you will be invited to complete and submit the Residence Admission Forms and the Doctor’s Report Forms.

Please complete the pre-screening forms below, so that we can decide whether we are able to meet your needs and offer you a place at the facility. Please read carefully and complete the forms.

1. Begin Here

Before you begin your application please read this document carefully. Vibrant Aging Community Center:Policy Documents outline our application process, policies, and rules for the center and tell you all you need to know about applying to VACC.

Vibrant Aging Community Center-Policy Documents

2. Complete the Pre-Screening Forms

Pre-Screening Forms
1. Resident and Representative General Information Online Form Print Form	4. Dietary Information Form
2. Activities of Daily Living Form
3. Health and Medications Information Form

Please print these forms and bring them into the center or use the button below to send them to the VACC Center administration.

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NB: Please do not complete the Application forms below until we have informed you that you have satisfied the screening process. We will then invite you to apply for residency at VACC using the forms below.

3. Complete the Residence Admission Forms & Doctor’s Report Forms

Admissions Application Forms	Doctor’s Report Forms
1. Residency Agreement Form	1. Doctor’s Report: Physical Health Status/Capacity for Self-Care Form
2. Preferences for Social, Recreational, Rehabilitative Activities Form	2. Doctor’s /Nurse Practitioner’s Consent for Administration of Medications Form
3. Personal Items Inventory Form	3. Doctor’s/Nurse Practitioner’s Routine Orders Form
4. Evacuation Disaster & Relocation Plan Form	4. Tuberculosis Screen Test Results Form
5. Acknowledgment Form

Please print these forms and bring them into the center or use the button below to send them to the VACC Center administration.