• Introduction
• Community Palliative Care Team
• Hospice at Home
• In-Patient Unit
• Lymphoedema Clinic
• Bereavement Service
• Day Hospice
• Education Department
• Referral and Criteria Forms for Download

Referral and criteria forms are placed here for download and saving to your own computer after which they should be printed, completed and faxed for the attention of the Community Team on 01543 434560

Please note however that forms will be updated on a regular basis, and you should therefore check this site periodically in order to ensure that you are using the most up to date form.

For security reasons please do not return forms by email.

To download Referral forms:

Click here for a St Giles Referral form

Click here for a Referral to IPU (supplementary form)

Click here for a Referral to Hospice at Home (supplementary form)

Click here for a Referral to the In Patient Unit for Respite (supplementary form)

For further information about the referral criteria to St Giles:

Click here for Referral Criteria to the Community Team

Click here for Referral Criteria to Hospice at Home

Click here for Referral Criteria for Respite