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  Assisted Living Annual Report
Current Survey: 2019
Assisted Living Online Survey
If you encounter technical issues which prevent you from completing the survey, then please click the Blank Report Form link, print the PDF, manually fill it out, and FAX it to David Rasmussen at 501-569-8538.
All information given in this report should be for services rendered to clients in Arkansas. A seperate report must be submitted for each county served by each agency.
The Survey due date is
February 1st, 2021