Enter Your Organizations Free Listing Below For The 2008 Edition! !

THIS SECTION IS TEMPORARILY OUT OF SERVICE UNTIL APPROXIMATELY MONDAY 6/23/08. PLEASE CHECK BACK TO ENTER YOUR ORGANIZATIONS INFORMATION, OR TO VERIFY INFORMATION PREVIOUSLY ENTERED, IN OUR ENTIRELY NEW AND UPDATED INFORMATION ENTRY SYSTEM. OUR DEADLINE FOR ENTERING YOUR ORGANIZATIONS INFORMATION WILL BE EXTENDED TO 7/3/08 DUE TO THIS INCONVENIENCE. THANK YOU FOR YOUR PATIENCE AND UNDERSTANDING. 

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2008 CATEGORY LISTINGS ENTRY FORMS

2008 ST. LOUIS REGIONAL EDITION

The 2008 St. Louis Regional Edition - Information For Older Adults RESOURCE GUIDE will be published in August 2008. As the most comprehensive publication for our region, it is endorsed by Missouri Attorney General Jay Nixon, Mid-East Area Agency on Aging, St. Louis Area Agency on Aging, Area Agency on Aging of Southwestern Illinois, CORP, Breakthrough Coalition and OASIS. It covers the Missouri counties of St. Louis, Franklin, Jefferson, St. Charles and St. Louis City. It also covers the Illinois counties of Bond, Clinton, Madison, Monroe, Randolph, St. Clair and Washington. If your organization provides products and/or services for older adults in this coverage area your organization qualifies to receive a free listing.

 

In addition to your free listing, we encourage you to support the publication with a paid advertisement. We also hope that you will offer access to our Information For Older Adults RESOURCE GUIDE to your website visitors by adding the following link to your website:

 

   Copy the logo to the left with a link to: http://www.stlouistimes.com

 

Below you will find all of the categories of information scheduled to be included for 2008. Find the category that most accurately represents your product or service and complete the information as requested. In the event your company provides products or services in multiple categories, please limit your listings to a maximum of three categories, if possible. The completed 2008 CATEGORY LISTINGS FORM should be submitted to us NO LATER THAN June 1, 2008. Thank you so much for your participation!

 

NOTE: For quality assurance purposes, even if your listing information has NOT changed from

              the previous year we request that you update your organization's information each year. 

 

 

2008 LISTING CATEGORIES

 

(Click on any category to go directly to it)

 

 

                                        Abuse & Neglect                                                        Long Term Care Insurance (NEW!)

                                        Adult Day Services                                                    Medical Equipment & Supplies

                                        Advocacy                                                                    Mental Health Services & Support Groups

                                        Aging Information & Referral                                    Other Programs, Services & Providers

                                        Disability Services                                                     Pharmacies

                                        Geriatric Care & Case Management                       Public Benefits

                                        Geriatric Physicians                                                   Respite Programs

                                        Home Health, Personal & Professional Care         Senior Centers & Food Resources

                                        Hospice                                                                       Transportation

                                        Hospitals & Health Services                                     Veterans Services

                                        Housing Resources & Home Modification              Volunteer Opportunities

                                        Legal, Financial & Estate Planning                          Website Resources (National or Web Based Only)

                                        

                                      Housing Options - An in-depth Housing Guide for older adults including 

                                        apartments/condos, CCRC’s, RCF’s, ALF’s and skilled nursing facilities

 

ABUSE & NEGLECT - Today's Date (MM/DD/YYYY):

Name of person entering this information - First Name: Last Name:

Company: In business since (year):

Street Address: City: State: Zip Code:

Phone: Fax: Email: Website:

Place an “X” in front of each county that your company provides service(s) to:

MISSOURI: Franklin    Jefferson    St. Charles    St. Louis    St. Louis City

ILLINOIS:    Bond    Clinton    Madison    Monroe    Randolph    St. Clair    Washington

Description of Services (please try to limit to 50 words or less):

 

Press "Submit" button to have your free listing included in the 2008 St. Louis Regional Edition.

ADULT DAY SERVICES - Today's Date (MM/DD/YYYY):

Name of person entering this information - First Name: Last Name:

Company: In business since (year):

Street Address: City: State: Zip Code:

Phone: Fax: Email:Website:

Private Pay Rates:Hours:

Transportation Available (If yes, describe):  Transportation:

Meals Provided (If yes, describe): Meals:

Place an “X” in front of each county that your company provides service(s) to:

MISSOURI: Franklin    Jefferson    St. Charles    St. Louis    St. Louis City

ILLINOIS:    Bond    Clinton    Madison    Monroe    Randolph    St. Clair    Washington

 

Press "Submit" button to have your free listing included in the 2008 St. Louis Regional Edition.

ADVOCACY - Today's Date (MM/DD/YYYY):

Name of person entering this information - First Name: Last Name:

Company: In business since (year):

Street Address: City: State: Zip Code:

Phone: Fax: Email:Website:

Place an “X” in front of each county that your company provides service(s) to:

MISSOURI: Franklin    Jefferson    St. Charles    St. Louis    St. Louis City

ILLINOIS:    Bond    Clinton    Madison    Monroe    Randolph    St. Clair    Washington

Description of Services (please try to limit to 50 words or less):

 

Press "Submit" button to have your free listing included in the 2008 St. Louis Regional Edition.

AGING INFORMATION & REFERRAL - Today's Date (MM/DD/YYYY):

Name of person entering this information - First Name: Last Name:

Company: In business since (year):

Street Address: City: State: Zip Code:

Phone: Fax: Email:Website:

Place an “X” in front of each county that your company provides service(s) to:

MISSOURI: Franklin    Jefferson    St. Charles    St. Louis    St. Louis City

ILLINOIS:    Bond    Clinton    Madison    Monroe    Randolph    St. Clair    Washington

Description of Services (please try to limit to 50 words or less):

 

Press "Submit" button to have your free listing included in the 2008 St. Louis Regional Edition.

DISABILITY SERVICES - Today's Date (MM/DD/YYYY):

Name of person entering this information - First Name: Last Name:

Company: In business since (year):

Street Address: City: State: Zip Code:

Phone: Fax: Email:Website:

Place an “X” in front of each county that your company provides service(s) to:

MISSOURI: Franklin    Jefferson    St. Charles    St. Louis    St. Louis City

ILLINOIS:    Bond    Clinton    Madison    Monroe    Randolph    St. Clair    Washington

Description of Services (please try to limit to 50 words or less):

 

Press "Submit" button to have your free listing included in the 2008 St. Louis Regional Edition.

GERIATRIC CARE & CASE MANAGEMENT - Today's Date (MM/DD/YYYY):

Name of person entering this information - First Name: Last Name:

Company: In business since (year):

Street Address: City: State: Zip Code:

Phone: Fax: Email:Website:

Hours: Fees:

Place an “X” in front of each county that your company provides service(s) to:

MISSOURI: Franklin    Jefferson    St. Charles    St. Louis    St. Louis City

ILLINOIS:    Bond    Clinton    Madison    Monroe    Randolph    St. Clair    Washington

Description of Services (please try to limit to 50 words or less):

 

Press "Submit" button to have your free listing included in the 2008 St. Louis Regional Edition.

GERIATRIC PHYSICIANS - Today's Date (MM/DD/YYYY):

Name of person entering this information - First Name: Last Name:

Physician Name:

Street Address: City: State: Zip Code:

Phone: Fax: Email: Website:

Hospital Affiliation(s) if any:

Other Accreditations:Specialty:

Member of the American Geriatric Society (AGS) (Y/N):

Certificate of Added Qualifications in Geriatric Medicine (Y/N):

 

Press "Submit" button to have your free listing included in the 2008 St. Louis Regional Edition.

HOME HEALTH, PERSONAL & PROFESSIONAL CARE - Today's Date (MM/DD/YYYY):

Name of person entering this information - First Name: Last Name:

Company: In business since (year):

Street Address: City: State: Zip Code:

Phone: Fax: Email:Website:

Medicare Provider (Y/N):     Medicaid Provider (Y/N):     CCP Provider (IL Only) (Y/N):  

Do you offer 24-hour care? (Y/N): Are you bonded? (Y/N):     Are you insured? (Y/N):

Can you provide? (Y/N): Companion Services: Home Health Aides:   Skilled Nursing:

                                  Homemaker Services:        Chore Services:

Place an “X” in front of each county that your company provides service(s) to:

MISSOURI: Franklin    Jefferson    St. Charles    St. Louis    St. Louis City

ILLINOIS:    Bond    Clinton    Madison    Monroe    Randolph    St. Clair    Washington

 

Press "Submit" button to have your free listing included in the 2008 St. Louis Regional Edition.

HOSPICE - Today's Date (MM/DD/YYYY):

Name of person entering this information - First Name: Last Name:

Company: In business since (year):

Street Address: City: State: Zip Code:

Phone: Fax: Email:Website:

Place an “X” in front of each county that your company provides service(s) to:

MISSOURI: Franklin    Jefferson    St. Charles    St. Louis    St. Louis City

ILLINOIS:    Bond    Clinton    Madison    Monroe    Randolph    St. Clair    Washington

 

Press "Submit" button to have your free listing included in the 2008 St. Louis Regional Edition.

HOSPITALS & HEALTH SERVICES - Today's Date (MM/DD/YYYY):

Name of person entering this information - First Name: Last Name:

Company: In business since (year):

Street Address: City: State: Zip Code:

Phone: Fax: Email:Website:

Place an “X” in front of each county that your company provides service(s) to:

MISSOURI: Franklin    Jefferson    St. Charles    St. Louis    St. Louis City

ILLINOIS:    Bond    Clinton    Madison    Monroe    Randolph    St. Clair    Washington

Description of Services (please try to limit to 50 words or less):

 

Press "Submit" button to have your free listing included in the 2008 St. Louis Regional Edition.

NOTE: If your organization has multiple Housing Options, please submit a listing for each separately.

HOUSING OPTIONS - Today's Date (MM/DD/YYYY):

Name of person entering this information - First Name: Last Name:

Company: In business since (year):

Street Address: City: State: Zip Code:

Phone: Fax: Email:Website:

Enter below the number of units or beds, and cost or range of cost, for each of the applicable housing options that you offer:

Independent Living Apartments/Condo's (# of Units).......Cost or range of cost per day/month $

Independent Living CCRC's (# of Units).........................Cost or range of cost per day/month $

RCF / ALF (# of Units or Beds)....................................Cost or range of cost per day/month $

Skilled Nursing Facility (# of Beds)...............................Cost or range of cost per day/month $

Methods of payment accepted. Enter an "X" below to all that apply:

Private pay Sliding scale Medicare Medicaid Private Insurance

Are Entry Fees Required? (Y/N): If yes, how much? $ Utilities Included? (Y/N):

Are Monthly Fees Required? (Y/N): If yes, how much? $ 

Is a Security Deposit Required? (Y/N): If yes, how much? $

Are Meals Included Per Day? (Y/N):  If yes, how many?

Please answer with a Y or N as to whether you provide the following services:

Alzheimer’s/Dementia Care Available    Medicare or Medicaid Approved

Rehabilitation Services Available