We report on the application of the Trust-Confidence-Distrust (TCD) framework of Gans et al. (2003) to the task of modeling trust relationships in a large metropolitan health service. We investigated the relationships between an acute stroke ward and a specialist stroke rehabilitation ward by examining the patient handover process that links each ward’s activities. The case study provided evidence that the model works in real-life settings. In addition, we gained valuable insights in the applicability of the framework in a formal organizational, rather than more loosely connected network setting.