Patient self-referral form

Primrose Hospice is happy to accept self-referrals to our Clinical services.

These referrals can be made by an individual, a family member or by a patient’s GP.

After your patient referral form has been received, a member of the Clinical team will review it and call to discuss different care options available at Primrose.

To talk to someone at Primrose Hospice, please call during office hours on 01527 871051.

If you would like to speak to someone about being referred to our Family Support services including bereavement support, please call 01527 889799.

    Can patient be seen as an Outpatient or in a Day Hospice setting?

    Who should we contact?

    Has the patient given you consent to refer them to Primrose Hospice?

    Can we leave a message?

    Can we disclose where we are calling from?

    Is GP aware of referral?

    Do we have consent to contact your GP?

    Would you be able to travel to Primrose Hospice?

    If you are a clinician and are able to provide additional information, please email whcnhs.primrose.hospice@nhs.net