Request Our Services
Do you know someone living with a serious illness, and could benefit from our services? Anyone can make a referral to Delaware Hospice, including family members, friends, physicians, health care professionals, hospital staff or patients. Many times, referrals come from those who believe hospice is the appropriate path for an individual, or, who would like to make a connection to obtain further information.

If you’re not certain that hospice is right for you, a loved one or friend living with a life-limiting illness, please contact our office at 1-800-838-9800. A Delaware Hospice professional will assess the situation, and make appropriate recommendations.

Online Referral Form
We will contact you within 30 minutes during normal business hours, Mondays – Fridays from 8:00 a.m. to 4:30 p.m., Eastern Standard Time, or first thing the next morning. Or, you can fill out the form below and submit it to us on-line.

Important! During evenings, weekends, and holidays, please call us at 800-838-9800.


Patient's Name (*)
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Relationship (*)
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Telephone Number (*)
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Contact Name (*)
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Please tell us how we can help you (*)
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Election of hospice benefit - Informed Consent Form

Statement of Patient/Family Right and Responsibilities

 Delaware Hospice is accredited by The Joint Commission. Read Statement
3515 Silverside Rd. Wilmington, DE 19810      1-800-838-9800