Hospice referrals

Over 90% of patients considering or completing medical aid in dying in the US receive hospice care at the time of their death.

We are honored to promote good care for patients, no matter how they die. If your agency is fully participatory in aid-in-dying or simply supportive, we would like to get to know you better.

Please fill out the form below:

Hospice Information for Patient Referrals

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Name of Agency(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Name of person filling out this form(Required)

Email(Required)

What is your role in this hospice?(Required)

Anything you'd like us to know before we contact you?

For more information on our customized training and in-services, click the button below:

trainings for hospice staff

Teaching and supporting best practices for the care of patients considering or completing medical aid in dying.

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Over 90% of patients considering or completing medical aid in dying in the US receive hospice care at the time of their death.

Hospice Information for Patient Referrals

Next Steps: Install the Survey Add-On

Teaching and supporting best practices for the care of patients considering or completing medical aid in dying.