Referral or Inquiry Form
Learn more about VNA of Greater St. Louis' compassionate care services or let us contact you to make a patient referral by filling out the fields below. Subsequent correspondence will be related to your service inquiry only. You WILL NOT be added to VNA's marketing list.
Nursing Homes and Assisted Living Inquiries
Self-Referral or Inquiry
If you have questions regarding hospice or VNA, feel you or a loved one may benefit from hospice but do not have an attending physician, or if you would like VNA to contact your attending physician for a referral to hospice, simply fill out the fields above or call (314) 918-7171 Monday through Friday from 8:00 am to 4:45 pm.
If you call, please inform the operator you would like to make a hospice referral.
To make a referral by telephone:
Call (314) 918-7171 Monday through Friday, 8:00 am to 4:45 pm or (314) 918-7111 evenings and weekends. Please specify that you would like to make a hospice referral.
Please provide the following information:
Patient’s name, address, phone number and date of birth
Doctor’s name and phone number
Diagnosis and treatment
To make a referral by discharge order:
Physicians simply write “Refer to VNA Hospice care for Hospice” on the discharge order and the discharge planner can fax the order along the above information to (314) 918-8054 or call (314) 918-7171. We will assess the patient in the hospital, their home, or a skilled nursing facility.
VNA will coordinate details including:
Patient and caregiver teaching/training
Skilled nursing, therapies and hospice specialty support services
Supplies and equipment
Pharmaceutical delivery arrangement
Physician/prescription order confirmation