This is a non-urgent referral form. If your referral requires urgent attention, please contact us on 03 473 6005.
Otago Community Hospice provides specialist palliative care to people with a life limiting illness. Our multidisciplinary team works in partnership with the patient, family and community health providers.
You can refer anyone living or staying in Otago with:
- Active, progressive disease no longer responsive to curative treatment with a prognosis likely less than twelve months.
- Complex symptoms (physical, social, emotional or spiritual) resistant to standard care in the community
Our team appreciate sufficient supporting information
What we need from you: (either by fax or email)
- Completed Referral form
- Documentation confirming diagnosis
- Current medication list, including dose and frequency
- Recent correspondence from hospital specialist
- Most recent radiology reports and blood test results
Once you have submitted your referral successfully, you will receive a confirmation email with details of the referral.
If you do not receive acknowledgement email please call us on 03 473 6005.