How we help

Referral Forms

If you or someone you know is in need of help from Hospice Mississauga, please select and complete the appropriate referral. Please provide as much information as you are able.

Or you can download and print the form and submit it to us by fax at 289-724-0620 or by email: intake@hospicemississauga.ca

Hospice Referral

For anyone (regardless of age) who is diagnosed with a life limiting illness.

Go to referral

Bereavement Referral

To connect with grief support

Go to referral

HUUG Bereavement Referral

For children and youth, under the age of 18, coping with the loss of a significant person in their life

Go to referral

HUUG Palliative Referral

For children and youth under the age of 18, who have a significant person in their life diagnosed with a life limiting illness

Go to referral