For your convenience, we have included our long term care application online.  Please click on the following link to download (Adobe Acrobat format):
Good Samaritan Application

If you don't have the free Adobe Acrobat reader (required to view our application), please click the following to download the free reader:
Adobe Acrobat Reader

Please print and complete the application then return to:
Laura Tate
The Good Samaritan Home, Inc.
601 North Boeke Road
Evansville, IN 47711

Phone: (812) 476-4912
E-mail: ltate@goodsamhome.org