Home Hospice Package Request

Patient Name *
Date of Birth *
Age *
Gender *
Address *
Phone *
Email
When to start the service (Date) *
Legal Representative Name:
Mobile No (Primary)
Mobile No (Alternative)
Legal Representative Email

These Terms of Use (referred to as the "Terms" or "Agreement") serve as a legally binding agreement between The Patient Party and Hospice Bangladesh (referred to as the "Company"). To use the service described below, you must agree to these Terms of Use.

  1. The Company reserves the right to modify, vary, and change the Terms of Use or its policies related to the service. These modifications, variations, and changes will be effective as soon as an updated version is posted on the Hospice Bangladesh website. As a patient or family member, it is your responsibility to review the Terms of Use. Your continued use of the service after any such changes will constitute your consent and acceptance of such changes.
  2. Please take your time to carefully read these terms. By using the service (as defined below), you indicate that you have read, understood, accepted and agreed with the Terms of Use. Additionally, you agree to the representations made by yourself below. In case you do not agree with or fall within the Terms of Use of the service and wish to stop using the service, please refrain from continuing to use the service.
  3. HBD's main focus is providing home care services to patients. Their hospice staff team delivers these services at the patient’s residence. They offer consultation services over the phone or through visits, and they are available 24/7 to help with urgent matters and pain and symptom control. It's important to note that since the condition of the disease can change over time, HBD cannot be held responsible for its state.
  4. The patient's primary physician will collaborate with the hospice team and consult the hospice consultant when necessary to manage the patient's symptoms.
  5. The Palliative Care Team will consult with the patient's family members and provide advice through phone calls, mobile applications, email, and SMS.
  6. The website displays the cost of Hospice care. Patients are responsible for reading the terms of service.
  7. The staff at HBD ensures that the patient's home remains secure during their duty hours.
  8. HBD is fully dedicated to providing exceptional service to patients and their families with utmost courtesy and respect. HBD kindly requests patients and families to treat the staff with the same level of respect. Please be advised that HBD reserves the right to refuse service to anyone who uses offensive language or exhibits aggressive behaviour.
  9. The nurse will only do patient-oriented duties asked by the HBD team.
  10. Both parties, which are HBD and the patient's family, will ensure to maintain privacy and confidentiality.
  11. Either party can terminate the service by providing a notice at least 24 hours prior to the intended termination time.