Home from Hospital Pack Referral Form
If you are finding this form difficult to fill in for any reason, you can request a paper form to be posted to you by calling 0330 2000 103.
Home from Hospital Packs are delivered between 10am and 3pm, 7 days a week, 365 days a year.
We can deliver to any location in Hertfordshire. We can deliver to the client’s home, a neighbour, or to the hospital before discharge.
Provision of personal data: we cannot provide a service without a minimum amount of personal information. These sections of the form are mandatory on this form. Please ensure that you have the client’s permission to share their data, if you are completing the form on their behalf. Please see our full privacy statement on our website link below, or give us a call on the number above.
www.hils-uk.org/privacy-policy
Before you start
You can save the form at any time and return to it later by clicking the save button at the end of each page. If you do not want to create an account, you can skip this and either copy the link to your form, or provide an email address to receive a link to your draft form.
If you have any issues completing this form, please email: hertsmeals@hils-uk.org