PhoenixCare Initial / Subsequent Clinical Assessment
This is a patient interview designed to gather information on symptoms, health status, quality of life, advance directives, and financial burden.
Clinical Care Tools - Clinical Assessment Tools
PhoenixCare Hospice of the Valley
1510 East Flower Street
Phoenix, AZ 85014
How the grantee used this instrument:
The RN Case Manager used this assessment tool to identify patient-specific priorities for education, services, referrals and intervention. It was completed at least monthly at a home visit.
symptom assessment, function, outpatient, mental health, psychosocial
To use this tool:
You may print and copy this tool for your own use via the link under "To view this tool." Please credit source.
Adapted from the "Brief Fatigue Inventory" Charles Cleeland, 1998. Adapted from "The Brief Pain Inventory" by Charles S. Cleeland, 1982. Adapted from the Rand Mental Health Inventory by john E. Ware, 1979. Adapted from FACT Quality of Life Instrument.
To view this tool:
To view the tool in your browser left-click on the link below or to download to your computer right-click on the link and select "save as."
Posted June 26, 2003
Hospice of the Valley/PhoenixCare overview page
Promoting Excellence in End-of-Life Care was a national program of the Robert Wood Johnson Foundation dedicated to long-term changes in health care institutions to substantially improve care for dying people and their families. Visit PromotingExcellence.org for more resources.