Refer a Patient
Make a Referral
Three easy ways to refer a patient:
- Fill in the form for the referral below and once submitted our qualified team will start the process.
- You can download the form and fax or email it us.
- You can also call in the referral, you can contact us at 323-653-0544 with following information:
- Patient full name
- Phone number
- Physician name
- Diagnosis- current H&P
If you are referring from Acute Hospital Request Victoria hospice services on your discharge orders when ordering hospice services.