If you or someone you know is in need of community support from Bethell Hospice, please select and complete the appropriate referral. Please provide as much information as you are able.
All Bethell Hospice programs and services are provided at no cost, thanks to the generous support of our community, donors, and community partners.
Community Program Referral Forms
Support for those who are living with a life limiting illness and their families.
Support for those who are caring for someone in their life navigating a life limiting illness.
Community Bereavement Referral
If you are over 18 years of age and grieving someone close to you.
Community Child and Youth Support Referral
For children and youth, under the age of 18, who have a significant person in their life diagnosed with a life limiting illness or coping with the loss of a significant person in their life.
Community Program Consent Forms
Consent Service Agreement, Community Program
Form 1 of 2. Please also complete the Resident/Community Client Consent for Bethell Hospice Foundation below.
Resident/Community Client Consent for Bethell Hospice Foundation
Form 2 of 2.