Request a Brochure

Requesting a brochure about has never been easier!
Please complete the following information. Your brochure should arrive within one week of your request.

* Asterisk indicates a required item.

 

For whom are you requesting information?
(Please select all that apply)

Myself

Parent or In-Law

Grandparent

Other Relative

Friend


    Requested By:       *

    Company Name:     

    Address:                 *

    Suite #:                         City:  *

    State                        *    

    Zip  Code:               *

    Phone:                     *       Fax: 

    E-Mail Address:     *


    Which levels of care are you interested in?
    (Please select all that apply)

    Independent Living

    Assistance in Living

    24 Hour Skilled Nursing

    When are you interested in making a move to a community?
    (Please select one)

    Within 30 days
    Within 60 days
    Within 90 days
    Within 6 months
    Within 1 year
    Within 1-2 years
    More than 2 years

    How did you hear about One Kalakaua Senior Living?
    (Please select one)

    Link from another site
    Newspaper
    Magazine
    TV/Radio
    Direct Mailer
    Newsletter
    Yellow Pages
    Referral
    Other

    Comments:

If you have questions, please call (808) 949-1111 or e-mail francis@1kalakaua.com

 

 

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