Adult Day Health Care Program Forms

Listed below are the required enrollment forms for new and returning participants.  Please complete and return as soon as possible to secure your spot — due to strict adherence to infection control guidance, space will be limited.

We are looking forward to seeing you!

Social Day Care Enrollment Forms

Medical Model Adult Day Care Enrollment Forms

Return your completed Gurwin Adult Day Care forms to:
Jeraldine Fedoriw, LMSW
Chief Adult Day Program Officer
68 Hauppauge Road,
Commack, NY 11725
(631) 715-2520; jfedoriw@gurwin.org