Please consider the following information before filling out this form.

This referral is for me.

If you are a professional making a referral, please contact the office for the complete form.

Hospice offers a variety of short term services for people experiencing grief -

  • Anticipatory Grief - Someone close to you is facing terminal illness and death.

  • Bereaved Current - Someone close to you has died.

  • Bereaved Historical - Someone close to you has died in the past and grief is resurfacing.

  • Palliative Diagnosis - You are facing terminal illness and death.

Clients are assessed for suitability and connected to a program matching their needs.

Our catchment are area includes Cedar/Cassidy, Regional District of Nanaimo (Areas A, B, C), Nanaimo and Lantzville.


Child/Youth Referral Form