Make a Referral

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Refer a Person for an Informational Visit or to Begin Service

We will help you with any of our available services, whether a consultation, palliative home care, hospice care, hospice house, children’s care or any of our specialty services.

CALL (816) 276-2700. There is always someone available to take your call and give you guidance.

Inquire online for yourself or for a friend or family member

INQUIRE NOW

Our Intake Department is pleased to assist you in setting up an informational visit and with the referral process.

We recommend that you ask one of our staff to visit with the family at home, nursing home, hospital or any place that is convenient for the family to gather. We can assess medical needs, fully explain our programs and services, answer any questions and help the family with the decision process.

There are options for every age, from infant to adult, and at every stage of serious illness, including people who are still receiving curative treatment.


 

Information for Physician’s Offices and Discharge Planners

To help ensure patient confidentiality, we request that confidential patient information be kept from emails.

To refer a patient, the following information is required and may be faxed:

  • The service your patient needs:

Palliative Home Care – for patients not ready for hospice, with skilled nursing needs. Patient must be homebound.
Hospice at Home, Assisted Living or Long-Term Care Facility.
Kansas City Hospice House™ – inpatient care to control pain or stabilize symptoms.
NorthCare Hospice House – inpatient care to control pain or stabilize symptoms.
Request a consultation to discuss options

  • Your name and contact information
  • Patient name and contact information
  • Diagnosis code(s)
  • Attending physician Cardiologist (if a cardiac patient)
  • History & Physical, Discharge Summary and Discharge Orders
  • Facesheet or document with DOB, SSN, address, insurance and primary contact
  • Current medication list Medicare Part D information or copy of card, if available
  • Physician signature, date and time

Referrals may be made by phone or fax. CALL (816) 276-2700    FAX (816) 444-1928

REFERRAL FAX FORM