Refer a Hospice Patient

Thank you for referring your hospice-eligible patient to Good Heart Hospice. Please complete the form below to submit your referral through our secured form below.

Click Here to See Disease-Specific Guidelines for Hospice Eligibility.

 

If you are a medical doctor, nursing home operator or a clinician who prefers to speak with one of our Care Consultants, please call (909) 989-9988 to make a referral over the phone.  You can also fax referral information to (909) 697-2426 at any time 24/7.

 

Hospice Referral Facts

Nearly 70% of Americans indicate they would prefer to die at home, if given a choice. Hospice care can help patients achieve that goal at end of life.

Patients’ families share a favorable view of hospice care:

  • More than 70% of families rate the care as “excellent” when patients received hospice care
  • Less than 50% of families rate the care as “excellent” when patients died in an institutional setting or with home health services.

One in five people reported that someone in their household had an experience with hospice care in the past year. Of those:

  • 87% said they have a positive opinion of hospice
  • 58% who had a very positive opinion

 

Submit Referral Details Below