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Referral Form - Patients with Terminal Illness Programs

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These programs are MSP based which improves accessibility for patients.  Physician referrals are mandatory for A New Beginning and Best Three Months courses.

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1) A New Beginning Without End - for patients with a diagnosis of a terminal illness and existential distress causing depression, anxiety and a sense of purposelessness and loss related to their diagnosis

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2) Best Three Months - for patients with a diagnosis of a terminal illness who wish to have an experience of preparing physically, emotionally, spiritually and practically for the experience of dying.

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3) Pre-fatal classes - for patients and their caregivers.  Realistic information about how to 'get affairs in order'.  How access support services, information on symptom control, advanced care planning, legacy work etc.  A road map to the last months or years of life.

For programs A New Beginning and Best Three Months, please download the referral form for your physician to complete and FAX to us.
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For Pre-fatal Classes, please fill out the form below

Thanks for submitting!

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