Referral forms

Referral form: In-patient, Hospice at Home and Wellbeing Programme

Admissions to the Hospice can only be arranged via a GP, District Nurse, Macmillan Nurse, Hospital Consultant or other Hospice services.

Referral form: Hospice Neighbours

Alternatively, if you have a patient who would like a Hospice Neighbour (a free service staffed by volunteers), please complete the Hospice Neighbour Referral form.

Referral form: Bereavement Services

Members of the public can refer themselves direct or via a healthcare professional to access our Bereavement Services.

Get in touch with our Clinical team

Referral forms should be downloaded and returned by email.

Family members and/or carers are welcome to contact us directly and talk to the Clinical Lead Nurse about how to access our Hospice services, please contact 01424 445177.

If you or your patient would like to know more about our Hospice Neighbour scheme please contact our Hospice Neighbour Officer on 01424 445177 or email us.