Refer a Patient | Forms
Hospice & Palliative Care
If you or a loved one believe it’s time to receive the compassionate care that hospice and palliative care provide, please complete the form below or call 24/7 (855) 812-1136. Once submitted, an AccentCare team member will immediately review the referral and will send someone to the bedside to begin discussing options with you to determine if hospice care is appropriate at this time.
Who can make a hospice care referral?
Anyone can make a hospice care referral, including a family member, friend, or the patient themselves. A patient’s doctor, hospital discharge planner, or other health care professionals involved in the patient’s care may also make the referral based on the patient’s prognosis. Trust, all referrals are handled in the strictest confidence.