Make a referral

Fax Referrals

To refer by fax, please download our Fax Referral Form and send to (831)430-9271.

Download Adobe Acrobat Reader to your computer.


Telephone Referrals for Hospice

To refer by phone, please contact the Hospice of Santa Cruz County Admissions Department at (831)430-3000.

Please provide the following information:

  • Patient's name
  • Patient’s phone number
  • Primary contact’s name and phone number
  • Doctor's name
  • Diagnosis: current and other significant medical data
  • Estimated prognosis of six months or less

To discuss eligibility, please call our Admissions Department at (831)430- 3000.


Hospital Discharge Orders 

Request Hospice of Santa Cruz County (Hospice SCC) when ordering hospice.