Referral Forms
At times, there have been issues affecting our advice line for healthcare professionals.
If you are trying to contact the advice line for health care professionals (07730 639 399) but have been unable to get through, please contact the team on our inpatient unit on our back-up number 01254 965865 who will be able to help you.
Referral Forms:
- CNS Referral Form
- Counselling Service/ Bereavement Support Referral Form - Document - PDF
- IPU Referral Form - Document - PDF
- Physiotherapy | CAST | Complementary Therapy Referral Form - Document - PDF
- Hospice at Home Referral Form - Document - PDF
Referral are accepted for any of the following reasons:
- Patients with progressive disease of any cause who have complex pain and/or symptom control issues
- The patient and/or their carer has psychological and/or spiritual or social needs
- The patient needs end of life care (this encompasses a range of needs and timescales - from those patients thought to be in their last year of life eg support for advance care planning to those of patients in their last hours/days of life)
Referrals are accepted from senior healthcare professionals including hospital doctors, GPs, district nurses, specialist nurses (all specialities), ward nurses, nursing home matrons, community matrons.
For support and wellbeing services, clients may refer themselves.