Referrals

We welcome referrals for patients who may benefit from our specialist palliative care services

Make a referral

Referrals can be made by healthcare professionals, including General Practitioners (GPs), specialist medical practitioners, or community agencies. Please ensure your patient resides within the Tōtara Hospice catchment area.

Our catchment area spans across South and South-East Auckland.
You can check on the map adjacent or call us at (09) 640 0025 to confirm specific address details.

Make a referral

To ensure patients receive the most appropriate care, referrals to our Specialist Palliative Care services should meet the following criteria

  • Active, progressive, and advanced disease Patient has advanced disease with limited prognosis; focus is on quality of life, not curative treatments
  • Complex needs exceeding the capability of primary care Patient's needs surpass primary care, e.g., uncontrolled symptoms or severe distress
  • Consent to referral Patient and/or their enduring power of attorney should agree to being referred to Tōtara Hospice
  • Residency and location Patient is a NZ resident within our catchment area; contact us if unsure or outside this area
  • Registered with local Healthcare Provider Patient is registered with a local GP or primary healthcare provider. Contact us if patient has no GP

Referral form

Palliative care is a team effort. At Tōtara Hospice, we work in partnership with healthcare professionals to provide advice and ensure that patients, carers and whānau receive the care and support they need. The sooner we are contacted after a patient’s diagnosis is now palliative, the more we can support you, and them. Our service is provided free of charge.

Totara Hospice Patient Referral Form
Next of Kin (or first contact details):
Family Practice:
Diagnosis and relevant medical history:

Please confirm does the patient have any Covid-19 symptoms or status updates:

Medications:
Presenting reason for referral:
Physical:

Please provide a description of the patient’s physical, psychological, social, and emotional condition.

Include any relevant medical history, current treatments, and key factors influencing care

Psychological:
Social:
Carer:
Is the patient aware of the diagnosis and likely prognosis?
Other services involved:
If your referral is urgent please phone the hospice directly on 09 640 0025 to discuss with the community or inpatient team.
Please fax or email corroborating documents, letters of discharge, blood tests and clinic letters to support the referral.
Please ensure that patient has agreed for Hospice involvement: