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718-472-1999

info@hospiceny.com
30-30 47th Avenue, Suite 635 
Long Island City, NY 11101
Serving The Bronx, Brooklyn, Manhattan, Queens, and Nassau County
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Patient Information/Forms

Forms

HONY Information

  • HoNY Handbook
  • HoNY Handbook Spanish
  • HoNY Handbook Chinese
  • Informed Consent / Election of Benefits Form (EN)
  • Informed Consent / Election of Benefits Form (SP)
  • Informed Consent / Election of Benefits Form (CH)
  • Health Care Proxy
  • Medicare Hospice Benefits Booklet
  • Family's Guide to Hospice Services


Online Forms (eSignature)

  • HoNY Admission Registration
  • DNR Order (Phys)
  • Admission Guidelines
  • 700-223 Health Care Proxy

VISIT

30-30 47th Avenue, Suite 635 
Long Island City, NY 11101

Serving The Bronx, Brooklyn, Manhattan, Queens, and Nassau County

CONTACT

718-472-1999
info@hospiceny.com

We have a team committed to admitting patients on the weekend.

CONNECT

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