When you make a referral to Avow Hospice (via
on-line form, fax, phone request), an Avow Hospice Admissions Care Coordinator will contact the patient/family and schedule a time to go to the patient’s place of residence (home, SNF, ALF) or hospital for an admissions visit.
During the admissions visit, the Avow Care Coordinator will explain Avow services and philosophy of care. He/she will answer questions regarding insurance coverage, medication coverage and equipment. If/when the patient/family elects Avow services, consent for care forms are prepared by the Coordinator for their signature. The primary care team typically meets with the patient the following day.
After the initial admission visit, Avow will send you initial admission orders (PPOC). You will be invited to choose your level of involvement (refer to the “
How Avow Helps You” page link). Once the admission process is complete, we’ll send you a letter notifying you that
your patient qualifies and has been admitted to the Avow Hospice program.
We accept patient referrals 24 hours a day, seven (7) days a week.
You may complete our on-line referral form or download, print and fax the referral form below (see "additional resources"). If you prefer to phone in your referral, call (239) 261-4404 and ask for the Admissions department. To help expedite the referral process, please have the following patient information ready:
- Referring Physician or Clinician’s name
- Physician/Clinician phone number
- Patient’s name
- Present location of patient
- Terminal diagnosis
- Urgent needs (if applicable)
- Family contact name (if applicable)
- Family contact phone number (if applicable)
- Is patient is aware of referral?