Patient Referral

Healthcare providers can use the Fast Fax Referral Form to send patient information to their local Agapé Hospice office. Please include Face Sheet, copy of insurance card if available, current H/P labs (within 6 months) and most recent Physician Notes with submission.

Fast Fax Referral Form

Our family wants to thank Agape for the way your staff ministered to us during the decline of our father and husband, Joe Moss. We are so appreciative of the resources and services Agape provided us, and we're also thankful for the love and care your staff gave Joe and his wife, Ann. 


Sheila Moss, Greenville, SC