About the E-Referral Form

At Heart to Heart, we know it can be difficult to determine the right time for hospice care for your patients or loved ones. Often we have patients and families say that they wish they would have known about hospice care sooner. Referring as soon as possible after a terminal diagnosis can significantly increase the effectiveness of hospice care because it give the care team ample time to address the patient’s physical needs, as well as the emotional and spiritual needs of our patient’s and their loved ones.

After the initial referral is made, a Heart to Heart team member will meet with the patient and their loved ones to discuss available programs and services, and answer questions that they may have regarding hospice care. With the patient’s consent, and once the patient’s physician and our medical director determine that hospice is appropriate, our nurse will then assess the patient’s needs and create a care plan customized to meet those needs. We work closely with the patient’s physician to ensure effective communication and a smoother transition to hospice that maintains continuity of care for our patients.

Our goal is to make the referral process as easy as possible and have more efficient admissions for our patients and families, as well as for our referral sources. There are several ways to refer your patient to Heart to Heart Hospice. Download our app from Google Play for Android phones and tablets, or from the App Store for Iphones and Ipads, to quickly and securely refer your patients by phone or email, or fill out the information below to make a referral online.

Make a Referral