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Hope Hospice and Health Services > Services > Hospice Care > Hospice Patient / Family Referral

Count on Hope for Hospice Services

If you or a loved one has a life-limiting illness, the Hope Hospice team can provide compassionate, holistic care in the comfort of home. To ensure your comfort and well-being, our skilled caregivers focus on the whole you, not just your illness, to help you live each day to the fullest.

Hospice services require formal doctor’s orders before care can begin. Hospice is a fully covered benefit under Medicare and most private insurance plans. However, there are certain eligibility requirements; in short, the patient’s doctor must feel that the underlying terminal illness gives the patient a remaining life expectance of six months or less.

The Hope Hospice Admissions Team is happy to speak with your family to explain the details. Give us a call at (925) 829-8770.

How to Start Hospice Service

The admissions process begins with a referral. The patient’s doctor can use our easy physician’s referral form or fax orders to (925) 829-0117.

Alternatively, the patient, a family member or other care partner, or their social worker can start the process by completing our self/family hospice referral form. In this case, the Hope Hospice Admissions Team will follow up with the patient’s doctor to obtain the required medical orders.

Hope Keeps the Process Simple and Stress-Free

Once we’ve received a referral form, our Admissions Team will contact the patient or designated representative to gather information and set up an initial assessment. They also contact the patient’s doctor, who will need to provide the patient’s:

  • Diagnosis
  • History and medical records
  • Medical orders

MD HOSPICE REFERRAL FORM SELF/FAMILY HOSPICE REFERRAL FORM

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6377 Clark Avenue
Suite 100

Dublin, CA 94568-3024

Phone: (925) 829-8770

Main FAX: (925) 829-0868

Joint Commission Accredited State Licensed, Medicare and Medi-cal Certified

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MENU
  • ABOUT
    • Our Mission
    • Where We Serve
    • Careers
    • Press Room
  • SERVICES
    • COVID-19 Information
    • Hospice Care
      • Hospice Care Explained
      • Hospice Care FAQs
      • Hospice Eligibility Criteria
    • Palliative Care
    • Grief Support
      • For Adults
      • For Children and Teens
    • Dementia Support
      • Services Overview
      • Respite Program
    • Family Caregiver Support
    • Advanced Illness Care
  • GIVING
    • Make A Donation
    • Gift Planning
    • Donating Securities
  • VOLUNTEER
    • Program Overview
    • Volunteer FAQs
    • Volunteer Interest Form
  • EVENTS & RESOURCES
    • 2023 Crab Feed
    • 2023 Hike for Hope
    • Calendar of Events
    • Family Caregiver Education Series
      • Upcoming classes
      • Archived recordings
    • Publications
    • Testimonial Videos
    • Helpful Information
  • PATIENT REFERRALS
    • MD Referral – Hospice
    • Self/Family Referral – Hospice
    • MD Referral – Palliative
    • Self/Family Referral – Palliative
  • PROFESSIONAL EDUCATION
    • In-Service Presentations
    • Publications
  • BLOG

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