Contact Us

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Priority Placement Services
9115 E. Baseline Rd.
Suite C-102-13
Mesa, AZ 85209-7763
480-285-3700 Local
480-380-2274 Fax

Online:

Please fill in all the information to better serve you.

First Name: Last Name:
Home Phone: Cell Phone:
Email:    
Address:    
City:    
State:    
Zip:    
       
Please check the one that best describes mobility?
Cane Full Mobility
Walker Wheel Chair
       
Please check any of the following activities that assistance is needed with:
Bathing Dressing
Eating Toileting
Taking Medication(s) Walking
Incontinence (bladder/bowel) Getting in or out of bed
       
Memory care
Alert and oriented Some short-term memory loss
Moderate short-term memory loss Severe memory loss
       
Please choose the price range that is most appropriate
$2,000 to $2,500 $2,500 to $3,000
$3,000 to $3,500 $3,500 to $4,000
$4,000+    
       
Additional Comments