A Not-for-Profit Agency

[541] 382-5882

Offices In
Bend
Redmond
La Pine

Serving Central Oregon 24 hours everyday

Who can refer to Central Oregon Home Health and Hospice?

You can! Anyone can make a referral to COHHH: patients, families, social workers, healthcare providers, and physicians. We also encourage inquiries about our services and programs and make a commitment to follow-up on each request. Once a referral is made, our team will make an assessment and work collaboratively with you and your physician to determine which services or programs will best fit your need. Learn more about our services and programs.

How to refer a patient for services?

Referring a patient couldn’t be easier. Our Central Oregon Home Health and Hospice team is fully committed to meeting your patients’ needs. We admit patients 24 hours everyday of the year in Central Oregon.

There are 3 ways to refer:

  • Fill out the on line Referral Form below and submit.
  • Download a referral form and Fax to our Admission Coordinator at [541] 388-7839.
  • Call our main office at [541] 382-5882. 

To refer we will need the following basic information:

  • Patient Demographics: patient name, address and insurance information.
  • Recent medical records including any recent hospital records, office visit summaries, lab work, etc.
  • A written physician order specifying a skilled need for home health or hospice care.
Please specify patient needs:
Referral Information:
Referral Date:
Name of Person Completing Referral:
Email Address:


Patient's Last Name:
Patient's First Name:
Date of Birth:
Sex:
Patient Lives Alone:
Address 1:
Address 2:
City:
State:
Zip Code:
Phone Number:
Next of Kin/Caregiver:
Initial Order for:
Primary Diagnosis (related to admission):
Skilled needs of patient (please include frequency of visits):
Fax or email any pertinent chart notes/labs.
Fax number: [541] 388-7839

Questions: please call [541] 382-5882