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332 N. Bright Leaf Blvd, Suite C P.O. Box 2559 Smithfield, NC 27577 Phone (919) 9017344 Fax (319) 2507453Patient Enrollment Form Name DOB Address City/State/Zip Home Phone Cell Email Are you a current

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United Hospice of Eastern is a non-profit organization that provides end-of-life care and support services to terminally ill patients and their families in the Eastern region.

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Any organization or individual that operates a hospice in the Eastern region and meets the eligibility criteria is required to file United Hospice of Eastern.

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The purpose of United Hospice of Eastern is to collect important data and statistics about hospice care services in the Eastern region, improve quality of care, and ensure compliance with regulations.

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