Who can refer a patient?

Anyone can refer a patient. A patient may refer him/herself or he/she may be referred by a friend, caregiver, family member, social worker, nurse, hospital, nursing home or physician. Our staff will visit with the patient and family prior to admission to access the patient’s condition, verify eligibility and explain the services provided by Hospice Alliance.

When can a patient be admitted?

Any time of day or night. Hospice Alliance staff are available for you 24 hours a day, 7 days a week, including weekends and holidays.

How to refer a patient:

Call 1-800-830-8344 and ask for Admissions.

The admissions staff work with you to understand the potential patient’s condition and how to best proceed in caring for him or her. The following patient information will be requested:

  • Patient’s name
  • Patient’s birthdate
  • Social Security number
  • Patient’s phone number
  • Patient’s primary care physician’s name
  • Diagnosis
  • Current medications
  • Brief Health History
  • Patient’s physician’s name
  • Insurance Information/Medicare Number
  • Caller’s  name
  • Caller’s phone number
  • Relationship to the patient

After a patient has been referred, our Admissions nurse will contact the patient’s personal physician to obtain the information necessary to schedule an appointment or evaluation of the patient. We will work to schedule a time that is convenient to include loved ones and those that will have a role in caring for the person requesting service. If the patient resides in a long-term care facility, we are happy to coordinate the appointment so facility staff can be present.

Contact Us: 24/7/365

Online Patient Referral Form

Toll-Free 1-800-830-8344
Phone 262-652-4400
Fax 262-652-4516

Hospice Alliance
10220 Prairie Ridge Blvd.
Pleasant Prairie, WI 53158