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Friend or Family Referral

Online referral submission will be handled immediately Monday - Friday 8 - 5.   If you have a referral after office hours please contact our main number: (661)-410-1010.

General

 

 

Personal experience  Friend or family memberHospital 

Television RadioReflections  Website

 

Person Being Referred

You

By Themselves

Skilled Nursing Facility

Residential Care Facility

Yes No

Yes No

 

Yes No

Please fax all pertinent medical records to Hoffmann Hospice at 661-410-1110.

 You are about to submit personal information over the internet.  While Hoffmann Hospice will make every reasonable attempt to ensure that your information is kept safe, please understand that there is an inherent risk to exchanging confidential information by any means (electronic or otherwise). By submitting this form you acknowledge that you understand and accept this risk.