To make a referral to Springhill Hospice please select the service you require below:

Medical Professional Referral Forms

These referral forms must be completed by a healthcare professional and sent to nehgm.liaison@nhs.net

Inpatient Unit (IPU) Referral Form

Wellbeing and Supportive Care Patients Referral Form

SPCT / Hospice at Home / Night Sit Referral Form

Bereavement Service Referral Form

Counselling Service Referral Form

Self-Referral Forms

We are trialing self-referral forms for our Wellbeing and Supportive Care services.

If you feel you could benefit please complete the below form and send it back to nehgm.liaison@nhs.net

Wellbeing and Supportive Care Self-Referral Form

We can help

Please contact us if you have any questions about referrals relating to:

Hospice services: 01706 649920
Community/ Hospice at Home: 01706 752360

Contact us Visit our help centre