You may download, as a PDF, the admission form for Pocono Lutheran Village. After opening the document using Adobe Acrobat Reader, you will be able to print it. Complete the form and fax it to Patricia Stys, manager of marketing and sales, at (570) 426-4010. If you do not have Acrobat Reader, please click the link below to download Adobe Acrobat Reader free from the Adobe Web site.

Download Personal Care Admission Form (opens a new browser window)

For your convenience, information on obtaining rates is available through the following link: