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  • Ca Maitri Admissions Application

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RESET Former Colleague, Thank you for your interest in the Matrix Residence. Our 15bed facility is licensed as an ACFCI (Residential Care for the Chronically Ill), providing support to low income people.

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How to fill out the CA Maitri Admissions Application online

This guide provides detailed instructions on how to complete the CA Maitri Admissions Application online. Whether you are familiar with the application process or this is your first time, this step-by-step guide will help you navigate each section with clarity.

Follow the steps to successfully complete your application.

  1. Press the ‘Get Form’ button to obtain the CA Maitri Admissions Application and open it in the editing interface.
  2. Review the Maitri Admission Procedures carefully to understand the requirements and ensure that your client's situation aligns with the facility's priorities.
  3. Complete all fields from pages 3 to 18 thoroughly. Ensure that current insurance information is included and a doctor's signature with their license number is provided (with the exception of page 14 for hospice referrals only).
  4. Attach necessary documents such as the history and physical report, medication list, tuberculosis clearance (recent chest x-ray), and any other additional information as required like MediCal card, proof of residency, and financial statements.
  5. Upon completion, save your application changes and make sure to keep a copy for your records. Submit the form via mail or fax to the provided address at Maitri.

Ensure you complete and submit the CA Maitri Admissions Application online to initiate the admission process.

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