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 hospital is a tertiary care facility that is right off interstate. We get patients from across the country and around the world. This has been my most difficult placement. Assisting a patient back to Pakistan was easier than South Carolina. Your team will remain in my contact list. I only wish I had found them sooner. 

Blessings....

Misty Otey, RN, Case Manager