Professionals Refer Referral form and criteria Make a referral As an organisation working separately from the NHS, we require detailed information at the time of referral. Our Specialist Palliative Care Referral Form can be emailed or faxed to us. Urgent referrals For urgent referrals, we will do our best to meet the need within one working day, but please call us to highlight that an urgent referral has been emailed or faxed. Contact us to discuss referring a patient: Tel: 01323 434222 For submission of a completed referral form: Email (via NHS.net email address): [email protected] Fax: 01323 640409 If you are looking to refer a child or young person please use see our specialist referral page here for more information.