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Is Your Patient Ready?


You may want to consider consulting or referring your patient to Avow Hospice when:

  • your patient has a projected lifespan of 6 months or less
  • your patient and/or their caregiver/family is electing palliative care
  • you have documented a clinical progression of disease as evidenced by multiple ER visits and/or inpatient hospitalizations
  • your patient demonstrates a recent decline in functional status
  • your patient shows dependence in ADLs
  • your patient demonstrates a recent impairment of nutritional status
  • your patient is unable to care for self due to rapid disease progression
  • your patient requires considerable assistance and frequent care
You may also wish to refer to our Disease Prognosis Worksheets for more information.
 
Palliative Care Consults Available

An Avow Hospice physician will call on your hospitalized patients to assess them for appropriate palliative care upon request.  We can:

  • assess patients for pain management
  • sensitively deliver “bad news” about the extent of their illness
  • help resolve family conflicts regarding the continuance or withdrawal of medical treatments
  • serve as your partner in treating your hospital-bound patients, reducing your time for rounds.

To request a consultation, complete our on-line referral form, download and print our faxable referral form below or call (239) 261-4404.


Referral Fax Form
Healthcare professionals are invited to print and fax this form for patient referrals.