How We Can Help You
Persons who live in Helderberg basin. Persons over 12 years of age
Persons diagnosed with a life threatening illness such as: Cancer, Motor Neuron Disease, Multiple Sclerosis, End stage Chronic Obstructive Pulmonary Disease, End stage organ failure, HIV/TB, End stage Parkinsons
Patient’s requiring specialist palliative care from Helderberg Hospice are generally referred to our service by their treating medical practitioner. All referrals for service are assessed by our Inter-Disciplinary Team and individually assessed for suitability.
Referral forms are accessible by clicking on the buttons below.
Treating Medical Practitioner to complete the MEDICAL referral below.
Patient or family to complete the PERSONAL INFORMATION form below.
Medical Professionals, patients and family members may also request referral forms by e-mailing us on firstname.lastname@example.org. Once we receive your completed referral forms, we promise to get back to you within 48hrs to advise you of the status of your referral.