Make a Referral

Fax Referrals

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

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.