Activity Calendar Menu Weather Maintenance Request Request a Ride Comment Card Community Map Employee Mode Coming Soon The Borealis This function is coming soon Maintenance Request "*" indicates required fields HiddenLocation*Boone Ridge ILTimber CreekHilltop Springs ILHilltop Springs ALHilltop Springs MCHilltop SpringsFake, Broken BuildingManzanita VillageHiddenKiosk ID* HiddenSubmission Date/Time WelcomeUse this form to submit your maintenance request for BeginWelcome! Use this form to submit your maintenance request for Your First Name* Your Last Name* HiddenSubmitter Location of issue*Include your apartment number if the issue is in your apartment Please describe the maintenance issue/request*EmailThis field is for validation purposes and should be left unchanged. HiddenCommunity(Required)Fictional ShoresBoone Ridge ILHilltop SpringsTimber CreekSubmitter infoYour name(Required) First Last Cell Phone(Required)Will You Be Using a Wheelchair or Walker?(Required)Select oneWheelchairWalkerNoDestinationDestination Name(Required) Destination Address(Required) Street Address City SchedulingMinimum 1 day notice required Trip must comply with community requirements for availability on specific days.Trip type(Required) One way Round trip Trip date(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Must arrive at destination by(Required) Hours : Minutes AM PM AM/PM Return pick-up after(Required) Hours : Minutes AM PM AM/PM This is a REQUEST ONLY. A team member will contact you after you submit to follow up with your request and confirm scheduling/availability for you. YOUR RIDE IS NOT CONFIRMED UNTIL YOU HEAR FROM US. HiddenCommunity(Required)Fictional ShoresBoone Ridge RetirementHilltop SpringsTimber CreekSubmission Type(Required) Anonymous comment Comment with my name Requesting community staff to contact me Submitter infoYour name(Required) First Last I am a...(Required) Resident Family member / friend of a resident Employee Other Contact InfoContact me via...(Required) Phone Email Either/Both Phone(Required)Email(Required) Enter Email Confirm Email MessageEnter your message/comment(Required) Timber Creek 1st Floor Timber Creek 2nd Floor ADL Charting Timeclock Safety Report Staff: Please close this window before walking away to allow resident use of the kiosk.
