Pre-Admission Form



Please provide the following information and hit the 'submit' button. If you have any questions or need any assistance, please call our admission staff at 813-261-5500.

  • Demographic Information

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  • Financial Information

  • Reason for Skilled Nursing Center Placement

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  • MM slash DD slash YYYY

  • Contact Information

  • Demographic Information

  • MM slash DD slash YYYY

  • Financial Information

  • Reason for Skilled Nursing Center Placement

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY

  • Contact Information

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Silas Creek Rehabilitation Center

3350 Silas Creek Pkwy
Winston-Salem, NC 27103

CONTACT US
Phone: 336.765.0550
Fax: 336.765.0826


OPEN HOURS
24/7

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