Referral forms

Potential patients must complete a referral form, either filled out by yourself or a health care professional who wishes to refer you to our hospice.

Please note that for self-referrals we will need to speak to a health care professional involved in your care to make sure we have all the relevant information needed.

Forms can be emailed to, faxed to 01202 672660 or posted directly to us at 1 Crichel Mount Road, Lilliput, Poole, Dorset, BH14 8LT.

If you would like to speak to someone in more detail about referring yourself or someone to Lewis-Manning Hospice Care please contact a member of our team on 01202 708470 or email,

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Please get in touch with us on 01202 708470 or email

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