The City of Gaylord is experiencing issues with the North water tower that typically serves Otsego Memorial Hospital. Learn more here.

Hospice Referral Form

Email  *State Patient Name  *Date of Birth Name of person making referral  *Same as patient? Contact Person Same as patient? Same as referrer? Contact Phone Contact Email  *Is there a MDPOA (Medical Durable Power of Attorney)? Insurance Is there anything else you would like us to know that would make it helpful in following up with this referral?