Make a Referral

A medical practitioner can make a referral to the Inpatient Unit or the hospice at home community services by completing the following form, and return as per instructions below –

Specialist Palliative Care Service Referral Form.docx (word format)

Options for returning form: (Preferably in digital format and emailed please)

email to:

Specialist Palliative Care Community Services:

Hospice In-Patient Unit Referrals:

  1. Complete the above form and email to the relevant above email address.
  2. Print off the form, complete and post to:
    Hospice at Home Referrals,
    Milford Care Centre,
    or if an In Patient Unit Referral
    Hospice In Patient Unit Referrals,
    Milford Care Centre,
Please attach any relevant results, discharge letters, images etc. to your email

Thank you

More Information