PATIENT REFERRAL FORM

Anyone can request hospice services for hospice care. In fact, some patients refer themselves. We will contact the patient’s physician/caregiver to ensure that hospice care is the best choice. Once it has been decided to consider our care, the patient and family are asked to meet with a Primary Hospice Care, Inc. staff member to determine what the patient’s and family’s needs are and explain what services we can provide.

[Form id=”Referral Form”]