Form is currently under construction.  Please contact Shawn Allan at 330-668-2828 or Chris Smith at 330-666-1183 directly for information.  Thank you!

If you would like more information about The Village at St. Edward for yourself, a family member or a loved one, please complete the following information:

Name:

Address:

City: State: Zip:

Telephone Number:

Home:  Work:

E-mail Address:

What service are you interested in? Please select one.

Independent Living   Assisted Living   Nursing Care   Unsure

I am looking for information on behalf of:

Self      Parent      Friend      Relative      Client

Please indicate how we can assist you further:

Send an information packet.

Have an Admissions counselor contact me.

I would like to make an appointment 
    to tour The Village at St. Edward.

Please use the following space for any additional general information or comments you would like to share.  We ask that you please not send any confidential information on this form.

To send this form, click the submit button below. 
Thank you for inquiring about The Village at St. Edward.

Nursing Care: 330-666-1183 
3131 Smith Road, Fairlawn, Ohio  44333
Independent Living/Assisted Living: 330-668-2828
3125 Smith Road, Fairlawn, Ohio  44333

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