Refer A Patient

Anyone — whether it be a physician, family member, friend, or clergy — may refer a patient to Hospice & Palliative Care of the Piedmont. Admission to the program will be determined by our simple admission criteria. Patients should be referred to Hospice & Palliative Care as early as possible after a life-limiting disease is diagnosed. This will allow the patient & family to receive the maximum benefit from hospice services.

Thanks for your interest in referring a patient to Hospice & Palliative Care of the Piedmont!  We can accept your referral information via our secure online system. Once submitted, Hospice & Palliative Care of the Piedmont will contact you if additional information is required.  Thank you!

Click Here for the Referral Form

(The referral form will open in a new window or tab.)