Medical Professionals

Please send the following information ALONG WITH  the referral form at the bottom of the page:

1. DNR (Post form is not acceptable)

2. Hospice Election Statement (Hospice Agency of Choice for Family)

3. Face sheet

4. History and Physical

5. Palliative Care and Hospice notes

6. Medication list

7. Results of a negative COVID and FLU A&B test for home patients 24 hours prior to admission.

8. Hospitalized patients must have a complete respiratory panel to include COVID, FLU, and RSV 24 hours prior to discharge.

Once all the above information is received and reviewed, a member of the Hospice House of Williamsburg Clinical Team will contact you to inform you of possible admission and bed status.

Additional information

Guests must be assigned to comfort measures only prior to admission.

Admissions are accepted Monday through Friday.

Referrals will be reviewed during the weekend once all information has been provided.

Transportation MUST be scheduled no later than 1pm Monday through Friday.

Medication is to arrive the night prior or to arrive with the patient.

Oxygen and suction equipment must arrive prior to the patient’s admission.

To ensure we have completed a full review, we are unable to provide an admission decision until both the referral form and chart notes are received.

Please direct questions to the Clinical Director, Heidi Crocker, or Clinical Nurse Supervisor, Heather Van Buren, by calling the following number: (757) 253-1220

You can also contact us via email at clinicalservices@williamsburghospice.org

HOSPICE HOUSE FAX NUMBER – (757) 253-2599