Health Care Professionals –

Directions: Email completed forms to Haywood Street Respite at HSRreferral@haywoodstreet.org along with H&P and other pertinent documents. Call respite at 828-676-6756 to confirm that email was received.  Haywood Street staff will evaluate the appropriateness of the referral and will contact you by phone to confirm approval.

A few things to know about us:

• We are a non-skilled facility; patient must be independent with activities of daily living.
• The typical length of stay at Haywood Street Respite is 2 weeks.
• While reservations are not possible, a phone call to explore appropriateness of referral and inquire about openings is welcome. 828-676-6756.

Required Forms to email over to initiate review of a referral –

Fillable Respite Referral Form

Printable Respite Referral Form

Respite Referral Information and Instructions