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We ceaselessly strive for better quality of life out comes for our patients.
Refer Someone
Making a referral

Seeking specialized hospice care services shouldn't be limited to specific disease stages. Whether you're a healthcare professional or a family member, you can refer a patient to us at any point. However, research has shown that early referrals can result in better quality of life outcomes. A prompt referral means we can spend more time communicating with patients and loved ones, truly understanding their needs and seamlessly coordinating their care.


Determining when a patient is medically suitable for hospice care can be a complex decision. Thankfully, there are several telltale signs and symptoms to look out for:


  • Symptoms that are uncontrolled or chronic and negatively affect quality of life

  • A gradual decline in functional ability

  • Unintentional and progressive weight loss exceeding 10% in the last six months

  • Multiple chronic health conditions

  • Needs assistance with most daily activities

  • Frequent infections

  • Repeated emergency department visits or hospitalizations

  • Wounds that do not heal.

Determine your patient's eligibility for hospice care through our support, or allow us to assist you in initiating the discussion with them. Our Registered Nurses will evaluate and design a customized care plan that is most suitable for your patient's requirements.


Ready to explore hospice care for yourself or a loved one? Fill out the simple referral form below, or call us at (281) 751-8333.

Hospice Care Referral Form
Patient Information
Is the family aware that a referral is being made to Bluevine Hospice?
Who should we call to schedule the visit?
Is the patient in the clinic/hospital at the time the referral is being called in?
Is patient able to make own decisions and sign own consents?
Who should we call to schedule the visit?

(i.e. wait for call for referral visit until siblings have been spoken to, facility nurse desired to be present for visit, wait for family member in lobby prior to visit)

Brief history of progressive illness

You may attach the face sheet or other medical information:

Upload File

Thanks for submitting!

For Referrals Call (832) 751-8333
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