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Make a referral

There are several ways in which patients can be referred to St. Michael’s Hospice. These referrals can be made by any healthcare professional.

How to make a referral

The easiest way to refer is by downloading and completing the below referral form. Once completed, please email your form to: St. Michael’s Hospice Palliative Care Office: or Basingstoke and North Hampshire Hospitals Palliative Care Office: 

Please remember to provide as much information as possible on the form to enable the team to make informed decisions and effective assessment of patients and their families.

You can also make a referral by letter, email, face-to-face or by telephone and the information will be transferred to the form.

Please refer here for information on our catchment area.

  • Palliative Care Service Referral Form


Urgent referrals

If you have an urgent referral, please call the Hospice on 01256 848863 and ask to speak to the Senior Nurse (either In-Patient or Community Palliative Care Team) who will be able to help and respond to your call as appropriate.