Referrals - Hospice Care

We are here for you. Please submit your information and we'll get back to you as soon as possible.

Please enter your full name:

 

Email ( we will not send junk mail ):

 

Phone ( include area code ):

 

Full name of loved one you would like to refer:

 

Your association to loved one: Select Wife Husband Son Daughter Brother Sister Father Mother Other

 

Please describe the illness with which your loved one has been diagnosed:

 

Please select your county: Select Preston Braxton/Calhoun/Gilmer Wetzel Tucker Taylor Randolph Monongalia Barbour Marion Other

 

Questions or additional comments:

 

Or give us a call at 1-866-656-9790

 

Anyone can contact us about someone who may benefit from our services. If you would like to make a referral, please keep in mind that in order for a patient to be eligible for services offered through Hospice Care, he/she must:

• Be diagnosed with a serious illness.
• Desire palliative (comfort measures) rather than curative treatment.
• Be a resident of Barbour, Braxton, Calhoun, Gilmer, Marion, Monongalia, Pocahontas, Preston, Randolph, Taylor, Tucker or Wetzel County.