Guest House Referral
The form must be completed by a provider or other healthcare personnel at St. Mary’s Hospital or affiliate via this online form.
Notes: Please advise the guest this is NOT a reservation. They are on a waiting list and will be contacted by the guest house staff about availability. Housing is NOT free but financial assistance is available – we do ask for a suggested donation of $45 per night.
Form will open as a pop-up in a new window.
Incomplete forms will be returned for completion.
Photo ID is required for admission.