Download consent forms for onsite vision and hearing services coordinated through visiting providers at Park Place Nursing & Rehabilitation in Tyler, Texas. Forms may be returned by fax, email, mail, or hand delivery.
About These Forms
Park Place Nursing & Rehabilitation is pleased to coordinate onsite audiological and eye care services for residents through visiting providers. Residents and essential caregivers may be asked to download and complete the appropriate consent form(s) below.
Note: These services are provided through visiting providers. If you have questions about eligibility, scheduling, or form submission, please contact our team using the information below.
Download Consent Forms
Download the form(s) needed for the services requested. Forms are typically PDF documents.
Mobile Vision Care Consent Form
Download form (PDF)Adobe Reader may be required to view PDF forms.
How to Return Completed Forms
Completed forms should be returned to the attention of Park Place Social Worker Esther Moscaira.
- Faxing it to: 903-592-1088
- Hand delivering it to our facility
- Emailing it to: Social@ParkPlaceTyler.com
- Sending via U.S. Mail to: 2450 East 5th Street, Tyler, TX 75701
For additional information or questions, please contact Esther Moscaira, LBSW at 903-592-6745 or email Social@ParkPlaceTyler.com .
Need Help with Forms or Next Steps?
If you have questions about onsite vision or hearing services, consent forms, or how to submit paperwork, contact our team in Tyler, Texas and we’ll help you get pointed in the right direction.
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