Grief & Bereavement Referral

Referral Process

Step 1: Complete a Referral Form. There are two ways to do this:

Option A: Download the fillable referral form PDF. Once completed, this form can be emailed or mailed to Nipissing Serenity Hospice. You may also come directly to the hospice to fill out a paper copy, if preferred.

          Email:
          [email protected]

          Mail/In-person:
          Nipissing Serenity Hospice
          Attention: Grief and Bereavement Team
          799 John Street
          North Bay, ON    P1B 8T2


Option B:
Complete the online form below. Make sure to press the Submit button when you are done.

 

Step 2: Once we have received the referral, the referred individual will be triaged and they (or their guardian) will be contacted directly.

 

NOTE: Please ensure only ONE individual is referred per form admission. If multiple individuals are being referred, please fill out a form for each person.

 

Contact Us

Mailing address

Nipissing Serenity Hospice
799 John Street
North Bay, ON
P1B 8T2

General Inquiries

Email: [email protected]
Telephone: 705-995-3377
Fax: 705-995-3350
Clinical Fax: 705-995-3351