Thank you for your interest in Carillon Assisted Living. To help us provide you with the most appropriate information possible, please complete and submit the following form.

Are you looking for assisted living options for:
      Self
      Spouse
      Family Member
      Friend

For yourself or the person for whom you are inquiring, which best describes the current living situation:
      Live in own home independently (not using home health care)
      Live in own home and receiving home health care
      Live with family members/friends
      Live in a community for independent seniors
      Live in an assisted living community
      Short-term stay in a nursing home

How soon do you think you will need assisted living services?
      Immediately
      Within 3 months
      Within 6 months
      Within a year
      Not sure – just gathering information

Which type of service do you feel you will need?
      Assisted Living
      Alzheimer’s/Dementia care
      Respite
      Not Sure

Which Carillon Assisted Living communities would you be interested in?
      Asheboro
      Harrisburg
      Hendersonville
      Hillsborough
      Lincolnton
      Salisbury
      Southport
      Cramer Mountain (Cramerton)
      Shelby
      Newton

Please enter any comments or questions you have about Carillon Assisted Living below:

If you wish to receive an information packet by mail, please complete the following information:

If you would prefer to receive a phone call from one of our Marketing Directors, please provide the information below.