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For Healthcare Professionals

Make a Referral

If your patient is in need of hospice or palliative care, or if you would like to know more about our services, please call our Access Services Department at (800) 221-8022. If you are ready to make a referral, complete the Physician Referral Fax Form and fax it to us at (206) 320-7333.

Please provide us with the following information when making a referral:

  • Patient name
  • Face sheet
  • Copy of current medication list
  • Recent H&P
  • Hospital discharge summary or recent office visit notes to describe the patient's current clinical condition
  • Copy of physician's order for hospice care

Who Should be Referred for Hospice Care?

Read our comprehensive Tools and Guidelines for Determining Eligibility for Hospice. The information in this booklet may be helpful for determining hospice eligibility; however these are guidelines only. Please contact us at (800) 221-8022 anytime for assistance with identifying your individual patient needs.

Providence Hospice of Seattle provides comprehensive physical, emotional, and spiritual care for adults, children, and infants faced with an advanced or life-limiting illness.

Patients of all ages, with any of the following illnesses, may be appropriate for a hospice referral once eligibility criteria are met:

  • Amyotrophic Lateral Sclerosis (ALS)
  • Cancer
  • HIV/AIDS
  • Severe birth defects
  • Stroke

In addition, patients with the following end-stage diseases may also be hospice appropriate:

  • Alzheimer’s
  • Cardiovascular disorder
  • Dementia
  • Renal diseases
  • Liver disease
  • Lung disease

These are not exhaustive lists. To explore options, a Providence Hospice of Seattle liaison is available at no-charge to meet with patients and their loved ones to discuss possible hospice care. Please call (800) 221-8022 if you would like more information.