Schedule a Virtual Visit

Visitation Form

Visitation is currently open at the Episcopal Church Home and no appointment is necessary. We ask that you review our full list of guidelines prior to visiting. Due to the ever-evolving pandemic situation, these guidelines are subject to change.
Video chats are available on Thursdays only and can be scheduled using this online form or contacting Patti Cummings at 585.546.8439 x3710 or pcummings@EpiscopalSeniorLife.org. Google Duo is the platform used for video chats.
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Daytime Phone*
Evening Phone*
Email*
Second Visitor's Name
First Last
Second Visitor's Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Second Visitor's Daytime Phone*
Second Visitor's Evening Phone*
Second Visitor's Email*
Additional Visitors
First Last Phone
Resident's Name*
First Last
Resident's Floor*
Resident's Room Number*
Resident's Room Number*
Resident's Room Number*
Resident's Room Number*
Resident's Room Number*
Headset
- Resident needs headset
WanderGuard
- Resident has WanderGuard
Hidden
Visitation Type Booking*
Select date and time*

September 2023

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Additional Requests/Comments
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Comments
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First	Last	Phone