Guest House Referral

COVID-19 Update: We are focused on limiting the spread of COVID-19, therefore the Guest House will frequently evaluate occupancy and may limit the number of available rooms.

Instructions:
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 have a suggested room rate of 45.00 per night

Eligibility guidelines are established to clearly identify who can stay as guests at the Evelyn D. Reinhart Guest House. The guidelines will be applied without prejudice or favor.
In order to determine the guests eligibility to stay at the Reinhart Guest House, the following guidelines will be followed:

  • Guests and patient must live at least 30 miles from St. Mary’s Hospital.
  • Guests are encouraged to pay the suggested room rate of $45 per night towards their stay; however, no one is ever turned away due to their inability to contribute
  • Guests must be referred by a provider or other healthcare personnel at St. Mary’s Hospital or affiliate via the online referral form.
  • Guests under 18 years of age must be accompanied by a parent or guardian unless they are an emancipated minor or the primary caregiver for a child, parent, guardian, or grandparent.

If exceptions to our guidelines need to be considered please give us a call at the Guest House at 804-287-7300.

Incomplete forms will be returned for completion.
Photo ID is required for admission.

Referral Information

To be completed by the professional submitting the form.




Guest Information

Please provide information on the guests requesting a room at the Reinhart Guest House.