Make A Referral
Your Name
Name of Patient
Phone Number
Best Time to Call
ANYONE can make a referral to Hospice of Southern West Virginia - a family member, friend, neighbor, nurse, discharge planner, physician, patient, Hospice team member - ANYONE can make a referral to Hospice services.

A physician is not needed for a referral. Patients can be admitted from any home care setting: home, hospital, skilled nursing facility or doctor's office.

TO MAKE A REFERRAL TO HOSPICE OF SOUTHERN WV, PLEASE CALL: (304) 255-6404 OR 1-800-900-6404

OR COMPLETE AND SUBMIT THE INFORMATION BELOW AND SOMEONE WILL BE DIRECTLY IN TOUCH WITH YOU
Please provide the following details:
Any additional information you would like to provide: