Order Online

Thank you for your interest in joining Nursing Home INFO. Ordering an upgrade to your listing online is easy. Please complete the following form. You will be billed for the service. An invoice will be faxed or mailed to you. If you would prefer to order by telephone or have problems ordering online, please call us Toll Free at 800-536-2657.

 

Your First Name
Your Last Name
Your E-mail Address
Relationship to Facility	Administrator Corporate Administration Corporate Marketing Director of Marketing Director of Nursing Director of Operations Facility Manager Owner Web Site Designer Webmaster Other Relationship
If Other, Please Describe
Facility Name
Facility Address 1
Facility Address 2 (Optional)
Facility City
Facility State	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming
Facility Zip Code	-
Facility Telephone Number	- - Ext.
Facility Fax Number	- -
Facility E-mail
Facility Web Site Address
Please provide the following billing information if different from above.
Billing Contact First Name
Billing Contact Last Name
Billing Address 1
Billing Address 2 (Optional)
Billing City
Billing State	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming
Billing Zip Code	-
Billing Phone (Daytime)	- - Ext.
Billing Fax	- -

Select Advertising Package
	Premium Package	$249 per year
	Web Link Package	$129 per year
	Expanded Listing	$49 per year
	Facility Web Profile (1-page)	$300 per year
	Facility Web Site (5-page)	$500 per year
	I am interested in occasionally receiving information about other products and services that may benefit my facility.
By placing this order I agree that I am acting as an agent of the operator of the above described facility and may authorize this order. Assisted Living INFO is a subscription service that is performed for the operator of the facility and the service transfers to any new owner of the facility's operation. The facility is billed annually for continuation of the subscription. If the facility elects to cancel the subscription, it may terminate in writing within 15 days after the date of the annual billing. After that date the annual fee becomes due and payable. If the facility closes or elects to terminate the subscription within the term of this agreement, they may do so by notifying us in writing. The annual subscription fee or any unused portion is non-refundable.

 

About Nursing Home INFO   Membership Benefits   Advertising / Link Packages
Web Site Design Solutions   Upgrade Your Listing Now!   Add or Update Listing
Frequently Asked Questions   Senior Care Marketing Tips   Contact Us
Nursing Home Facility Search   Nursing Home INFO Home


LEGAL NOTICES:   Terms of Use   Privacy Policy