Hospital Readiness Information Form

This Hospital Readiness Form was created as a useful tool to enable individuals to have all of their medical information in one central location. This form can be shared with a family member and/or your emergency contact. In the event that a hospitalization is required, this form can be taken with you to assist in the continuity of your care during the stay. It can even be used for routine office visits.

The video above explains how to fill out the form step-by-step. Below you can download the form and the NY State Health Proxy form. (6/10/21)

Recent Accolades
  • Best Nursing Homes 2021
  • Best Nursing Homes 2013
  • RN of the year 2013
  • Silver Crown Award 2011
  • Heart & Hands Award
  • Optima Award 2003
  • Optima Award 2006
  • 2004 Nurse Scholarship Winner
  • 2006 Nurse Scholarship Winner
  • CNA Scholarship Winner
  • 2003 Spirit Award
Contact Us
Glen Cove Center for Nursing Rehabilitation

6 Medical Plaza
Glen Cove, NY 11542

Phone 516-656-8000
Fax 516-759-9370
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