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Make a referral

100 percent of physicians who have referred patients to Family Hospice and Palliative Care indicate that the referral was handled smoothly. In addition, 95.3 percent of family members tell us the care provided fulfilled the patient's wishes regarding end of life (from 2013 surveys).

To make a referral - you have options:

Call 1-800-513-2148
Email the Referral Form
Fax to 412-572-8492
or, fill out the online form below:

Name:

Address:

Date of Birth:

Family Contact:

Phone:

Email:

Relationship to you:

Diagnosis:

Insurance Information

Insurance Name:

Agreement Number:

Group Number:

Referring Physician:

Attending Physician:

Additional Patient Information:

Quality Recognition

"We Honor Veterans" Partner,
meeting the unique needs of veterans

Address & Phone

Information and Referrals
1-800-513-2148

Central Administration
& Inpatient Center
50 Moffett St.
Pittsburgh, PA 15243
412-572-8800

Lawrenceville Inpatient Center
310 Fisk St.
Pittsburgh, PA 15201
412-687-2030

Eastern Market Administrative Office
20 Sheraton Drive
Altoona, PA 16602
1-800-445-6262

Family Hospice shall accept referrals and provide services to all persons in need in its defined service area regardless of race, color, religion, sex, age, national origin, creed, limited English proficiency, handicap or disability, ability to pay, ancestry, sexual orientation, diagnosis, infectious disease, or DNR status, if applicable.