Referral form

Please note that for Inpatient Services the referral form will only be accepted from appropriate health care professionals. For example, Hospital Medical Teams, General Practitioners, Specialist Hospital or Community Palliative Care Nurse.

For Day Therapy services, patients can also self-refer by telephoning the appropriate Hospice site and asking for the Day Therapy Leader. Please do not fill in the form first as this will need to be completed with a member of the Hospice team.

If you have a life-threatening illness, or know someone who has and you feel you may wish to access hospice services, please do not hesitate to contact us for advice.

If you would like a referral form, please call us on:

St Ann's Hospice, Heald Green
Tel: 0161 437 8136

St Ann's Hospice, Little Hulton
Tel: 0161 702 8181

Neil Cliffe Cancer Care Centre
Tel: 0161 291 2912