Make a Referral

Carpenter Hospice has a comprehensive referral program. Our Intake Coordinator will come out to make an assessment either in your home or in hospital. The process will involve talking to you about your current healthcare condition, your support, and any symptoms you are experiencing. Admissions are based on priority, not on referral time. The Intake Coordinator will talk to you about how long this process usually takes.

Criteria for admission:

  • Over the age of 18
  • Valid Ontario Health Card
  • Burlington resident and/or family member in the surrounding area
  • Goals of care to be comfort and quality, not curative
  • Qualify for CCAC
  • Diagnosed with a terminal illness
  • Deemed to have a life expectancy of less than 3 months

Who can make a referral?

  • Family, patient, CCAC, attending physician, hospitals, or any other health care professional can make a referral.

Download our Referral Form. Completed forms can be mailed, faxed or dropped off at Carpenter Hospice.

If you will be visiting our facility please note that due to allergic sensitivities, Carpenter Hospice is a fragrance-free area. Due to health concerns arising from exposure to scented products, we are committed to providing a fragrance-free environment to all residents, visitors, employees, and volunteers. Fragrances are defined as any product that produces a scent strong enough to be perceptible by others, including but not limited to cologne, aftershave lotion, perfume, perfumed hand lotion, fragranced hair products, scented oils and/or similar products. We appreciate your cooperation. 

For more information, contact our Intake Coordinator at 905.631.9994 Ext 110 or .

The Carpenter Hospice