Hospice referral form template 2025

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Anyone can refer someone to hospice services a friend, your doctor, a pastor, a loved one. Its not necessary to have a doctors referral to go to hospice which means the patient can even refer themselves. Therefore, you and your family get the assistance you need. When you need it.
As the end of life approaches, physicians often initiate hospice referrals although other medical professionals and families can also recommend it.
A referral to hospice may be made by anyone, including but not limited to: Physicians. Hospital Discharge Planners. Social Workers.
You can do a self-referral. Call a local hospice agency and give them his medical history. It sounds like he should qualify for hospice services. The hospice can then request records from the hospital or doctors office.
While a doctors order is needed to receive hospice care, anyone can make the initial referral for care.
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This includes: A loved one. A family member. A physician. A friend. A neighbor. A community member. The patient themselves. The referral process itself is very simple. All it takes is a phone call to 1-800-733-1476. You may also complete the referral form on our website. Education is an Important Tool.

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