Request Information

Thank you for reaching out to the 
Middlesex Health Hospice Program!

Please complete the form below to request information about our program. A member of our team will respond to your message as soon as possible.

If you or your loved one is a current patient or your concern is time-sensitive, please call 860-358-5700 or message us through your MyChart patient portal.

Please note: We cannot process emergency requests from this form. If you are having a medical emergency, please call 911.

When you submit this form, your information will be sent to the appropriate Middlesex Health staff, who will help you schedule an appointment or complete your request.

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