Referrer InformationName*Title*Select OnePhysicianNurseCase ManagerDischarge PlannerOffice ManagerOtherFaculty/Office Name*Phone*Email Service*Select OneComfort CareHospicePatient InformationName*Is the Patient a Veteran?*YesNoSituation/CommentsHow did you come to choose Serenity?*Our referral staff will contact you soon for additional information before referral is complete. Online referral is not a guarantee of admission; all referrals are clinically reviewed by our full time Medical Director.CAPTCHA
