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Referrals to our Bethell Hospice Residential Program can be made either by the individual seeking service or by a medical services provider. Please fill in the form below to begin the Bethell Hospice Residential Referral process.
Once your Residential Referral Form has been accepted, the Residential Admission Agreement will also need to be completed.
For more information or if you need assistance in completing a form, please contact:
Dorothy Rankin, Intake Coordinator at 905-838-3534, ext. 2240 or firstname.lastname@example.org