Referral Form

Physicians caring for patients with any life threatening illnesses are encouraged to refer them to Hospice of Waterloo Region. Hospice has many programs and services that can help make life a little easier for someone coping with a life-limiting illness and their caregivers.

All our programs and services are provided free of charge.

Download Client Referral Form and fax the form to Hospice at 519- 743-7021.

Call Sooner 519-743-4114

To find out more about our programs and services please call us at 519-743-4114. All our programs and services are offered free of charge to families.

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