HomeOur careFamily servicesBereavementBereavement support referral (Professionals) From 27th March 2024, we will be offering our one-to-one bereavement counselling service only to those who have been affected by the death of someone who was cared for by St Wilfrid’s Hospice. More information about bereavement service changes Referrals from professionals We accept referrals from GPs and other professionals for individuals whose main presenting issue is grief. We're able to accept referrals based upon the following criteria: any adult 18 or over who has experienced a significant bereavement of someone who was a patient of St Wilfrid's Hospice, which is impacting upon their ability to manage day-to-day living, and who living in the catchment area of St Wilfrid’s Hospice. Please note, St Wilfrid’s Hospice is unable to provide crisis bereavement support or home visits. We are also unable to support patients who are already receiving psychological therapy from another service or who present a risk to others.Details of referrerName(Required) Dr.Mr.Mrs.MissMs.Prof.Rev. Prefix First Last Job title(Required)The service you work for(Required)Work phone number(Required)Mobile numberEmail address(Required) Personal details of who you are referringName(Required) MissMr.Ms.Mrs.Dr.Prof.Rev. Prefix First Last NHS Number (if known)As we move towards joined-up working with other healthcare organisations, providing us with the patient's unique NHS number enables us to quickly and accurately find them and the people most important to them, to facilitate improved care, treatment, counselling and support.Date of Birth(Required) DD slash MM slash YYYY Address(Required) Street Address Address Line 2 City ZIP / Postal Code Telephone number(Required)Mobile numberEmail(Required) GP Practice(Required)Name of GP (if known)Name of deceased(Required)Please note: from 27th March, our one-to-one counselling service will only be offered to those affected by the death of someone who was cared for by St Wilfrid’s Hospice. Details of the death(Required)Please explain in as much detail as you can so that we can provide the appropriate support.Date of death for the deceased(Required) DD slash MM slash YYYY Relationship of person being referred to the deceased?(Required)Is there any additional information that you feel would be helpful to share at this time?Please include the following: • The clinical need for the referral. What symptoms of complex grief is the client displaying? • Information about the impact the bereavement is having on the client’s ability to manage day-to-day living • Details of the bereavement, including (where known) when it took place, the cause of death etc. • Current medication • Details of any history of compulsive behaviours • Details of any current or past suicidal ideation and / or self-harming behaviours • Any other information we should be aware of. CAPTCHA