Female nurse helping man get up from a wheelchair

Refer A Patient

When To Make A Referral

The patient must have a life-limiting condition or terminal illness with a prognosis of six months or less, either due to a specific diagnosis or a combination of factors. At the end of six months, the patient will be reassessed to determine if hospice is still appropriate considering the progress of the disease. While determining life expectancy is not an exact science, the recent legislation states that, “a physician’s certification of a patient is based on clinical judgment regarding the normal course of illness.”

The patient must be aware of their condition, and both the patient and family must agree to hospice care, accepting palliative care over curative treatment.

A patient who might be eligible for and benefit from hospice care may demonstrate some of these symptoms:

  • Unplanned weight loss
  • Excessive sleeping throughout the day
  • Multiple hospital visits/stays in the past six months
  • Excessive swelling of the legs and ankles, even when feet are propped up
  • Difficulty breathing, even at rest or with increased oxygen levels
  • Weakness during activities of daily living
  • Frequent changes in medications
  • Pain that is poorly controlled
  • Loss of interest in activities
  • Not “bouncing back” after an illness
  • Not responding to current treatments or therapy
  • Loss of appetite
  • Confusion
  • Wounds that are not healing
  • Loss of speech
  • Infections
  • Not sleeping through the night due to pain, shortness of breath, or other symptoms

How To Make A Referral

Making a referral is simple:

Please call us at 678-583-0717 or fax the form below to 770-727-0202

Fax Referral Form

Other Helpful Documents

Hospice Indicators

Hospice vs. Home Health

Hospice vs. Palliative

Talking About Hospice

Symptom Worksheet

Eligibility Criteria