REQUEST INFORMATION

Anyone can begin the process of finding out if hospice care is the best option for someone affected with an illness. This form will give us basic information that is needed to help us begin the process.

Once you have submitted this information, one of our specialists will contact you shortly to discuss your needs and answer any questions you may have. Please be assured we will adhere to the contact times you have selected. You may also call us toll free at 1.866.861.0060 and initiate the process by phone.

Your Information

First name

Last name

Phone Number

Email address

Who do you think might benefit from hospice services?

Recipient Information

First name

Last name

Age of individual

Gender

Health issue or medical concern

Preferred time for us to contact you?

Solace, Teachings from the Wisdom of Dying is an in-depth hospice and palliative care education program, based on the documentary film, Solace: Wisdom of the Dying. The film was directed and produced by Camille Adair, RN and sponsored by Ambercare Hospice in the State of New Mexico. Participants will meet monthly at Ambercare offices throughout the state. Healthcare professionals may obtain 30 continuing education credits through webinars, facilitated by Camille Adair, who is the director of Education at Ambercare Hospice.