Tell Us Your Story

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Share Your Personal Experience

Do you have a personal experience with a family member or friend that involves an assisted living or personal care facility? Have you faced difficulties with an assisted living facility in Pennsylvania? Have you had a good experience that you’d like others to be able to have? Nothing is more valuable than your personal story. Real examples help regulators and lawmakers understand the need for concrete solutions.

PALCA wants to know the issues and challenges associated with assisted living, elder care and residential options for senior citizens and persons with disabilities in Pennsylvania. We value your privacy and will only post those stories on the website with your permission.

We want to make your voice heard. Tell us your story here:

*First Name 
*Last Name 
* Address 
*City 
*Zip Code  
*Email  
Daytime Phone (optional) 
Name of Assisted Living Facility: 
Your Experience: 

Permission:
I would be interested in speaking to the media. I understand you will contact me before referring a reporter to me.
I authorize PALCA to use my story, without compensation to me, on the PALCA website. I understand that PALCA will use my submitted text only for informational purposes. I hereby agree to hold PALCA and its affiliates harmless form any liability resulting from my statements and actions depicted or described in the information submitted.
I want to tell my story, but do not want it used on the web site or given to the media.

Please enter the black characters you see at right and press the Submit button.

  

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