Make a referral

If you would like to talk to someone about accessing our services please contact our information and advice service on 0300 330 9410 or

If you are a healthcare professional who would like to refer a patient to us use the relevant form below.

Hospice at Home

  • Please call 01543 434525 and we will help you with your referral.

Community Team

In Patient Care

N.B. If the patient is unknown to St Giles please use the Pan-Birmingham Form as well as the Pre-Admission Form.

Day Hospice

Lymphoedema Clinic

Planned Respite Referral

N.B. The patient will need to be known to a Clinical Nurse Specialist before being considered for planned respite.
If this is not the case, please complete and submit the Pan-Birmingham Referral Form as well.