About this template
Managing inquiries for a nursing home or senior care facility requires sensitivity, speed, and clear organization. Families searching for long-term care or rehabilitation options often have urgent questions and need reliable guidance from facility admissions teams. This Nursing Home Enquiry Google Form Template streamlines the initial contact process by capturing essential details about prospective residents, their care needs, and family preferences in one centralized place.
Designed for ease of use, the form collects key contact information, the nature of the inquiry, preferred communication times, and specific medical or personal requirements. Facility administrators, intake coordinators, and social workers can review submissions instantly, ensuring families receive timely, compassionate follow-ups. By moving this process online, your team can manage inquiries around the clock without getting bogged down by unstructured phone calls or missing crucial details.
Key features
- Collect detailed resident care requirements and inquiry types in one step.
- Capture preferred contact methods and best times to reach families.
- Track referral sources to understand how families discover your facility.
- Easily customize questions to reflect specific care tiers or room availability.
- Receive instant email notifications for every new family inquiry.
Use cases
Managing prospective resident inquiries for assisted living facilities.
Handling rehabilitation and short-term skilled nursing care questions.
Scheduling facility tours and family consultations.
Collecting initial demographic and care requirement data before intak…
Collecting initial demographic and care requirement data before intake interviews.
What this form collects
- Inquirer's Full Name (Short answer)Enter your first and last name.
- Prospective Resident's Name (Short answer)Enter the full name of the individual who may require care.
- Your Relationship to the Resident (Dropdown)Select the option that best describes your relationship.
- Email Address (Short answer)Provide a reliable email address for our admissions team to send informational materials.
- Contact Number (Short answer)Include your primary phone number.
- Mailing Address (Paragraph)Enter your street address, city, state, and zip code.
- Type of Care Needed (Checkboxes)Select the level of care you are inquiring about.
- Preferred Contact Method (Multiple choice)How would you prefer our team to reach you?
- Best Time to Reach You (Dropdown)Let us know when it is most convenient to speak.
- Target Timeline for Placement (Dropdown)When are you hoping to transition into a care facility?
- How Did You Hear About Us? (Dropdown)Tell us how you found our facility.
- Additional Questions or Message (Paragraph)Please share any specific questions, medical conditions, or details you would like us to know before we connect.
FAQ
How do I share this nursing home enquiry form with families?
You can easily share the Google Form by embedding it directly on your facility's website, emailing a direct link to interested family members, or sharing a QR code on printed brochures.
Can I customize the questions to match our specific care levels?
Yes. Once you open the template in Google Forms, you can add, remove, or edit any questions to align with your facility's specific programs, memory care units, or admission criteria.
Where do the inquiry submissions go?
All form responses are automatically organized into a connected Google Sheets spreadsheet, allowing your admissions team to track, sort, and respond to inquiries collaboratively.
Is this form template free to use?
Yes, this template is completely free to copy and use via Doc2Form and Google Forms.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.