Application

Ready to Get Started?

To get your admissions process started, please complete the online form below. We’re looking forward to receiving your application!

Questions? Interested in scheduling a tour of our facility? Please call Sister Damian, D.M., our Director of Admissions at 717-755-1964.

NOTE: All fields marked with a RED asterisk are mandatory.

For your convenience, you can download, print, and complete the admissions application offline. When you are finished, submit your application via email to [email protected] or via fax at 717-840-0010. 

You may also mail the application to Misericordia Nursing & Rehabilitation Center, ATTN: Admissions Director, 998 S. Russell Street, York, PA 17402

Step 1 of 7

  • Application for Admission

    Thank you for your interest in Admissions at Misericordia. Please complete the form below and we will be in contact with you shortly. All fields with a RED asterisk (*) are required. Thank you.
  • Personal Data