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Palliative Care Referral Phone: 5306217820 Fax: 5306227032 Patients Name: ___ DOB: ___ Diagnosis: ___ Primary Care Physician: I understand t hat the patient referenced above must have a qualifying diagnosis. Consultation services may be provided by a Board Certified Palliative Medicine Physician or a Board Certified Nurse Practitioner during palliative care services. Please admit to Palliative Care. If you feel your patient requires hospice care, please call 5306217820. ___ ___ Date:___ Print
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How to fill out palliative care referral phone

How to fill out palliative care referral phone
01
Gather patient information including name, age, and medical history.
02
Review the patient's current diagnosis and treatment plan.
03
Identify the specific needs for palliative care (e.g., pain management, psychological support).
04
Locate the palliative care referral phone number for your facility.
05
Call the referral phone and provide the patient's information and needs.
06
Follow any additional instructions provided by the palliative care team.
Who needs palliative care referral phone?
01
Patients with serious, life-limiting illnesses.
02
Individuals experiencing significant pain or symptoms that are difficult to manage.
03
Patients who require support with emotional, psychological, or spiritual concerns.
04
Families needing assistance in navigating end-of-life care decisions.
05
People seeking an additional layer of support alongside curative treatments.
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What is palliative care referral phone?
A palliative care referral phone is a dedicated contact number that patients, families, or healthcare providers can use to initiate a referral to palliative care services.
Who is required to file palliative care referral phone?
Healthcare providers, such as physicians, nurses, and social workers, are typically required to file a palliative care referral phone based on patient needs.
How to fill out palliative care referral phone?
To fill out a palliative care referral phone, one needs to provide patient information, medical history, reason for referral, and any other relevant details specific to the patient's condition.
What is the purpose of palliative care referral phone?
The purpose of the palliative care referral phone is to streamline the process of accessing palliative care services and ensure timely support for patients with serious illnesses.
What information must be reported on palliative care referral phone?
Information that must be reported includes the patient's demographics, diagnosis, prognosis, current treatment plan, reason for referral, and any specific needs or concerns.
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