Promoting Excellence : Symptom Sheet (Balm of Gilead)

Balm of Gilead: Symptom Sheet

The Symptom Sheet is used by the physician or nurse to assess and track the level of the patient's symptoms.

Clinical Care Tools - Clinical Assessment

Cooper Green Hospital
The Balm of Gilead Center
1515 Sixth Avenue South
Birmingham, AL 35233

Marc Sussman
[email protected]

How the grantee used this instrument:
This symptom sheet was used by Cooper Green project staff administered to palliative care inpatients to assess and track the level of patient's symptoms.

quality of life, symptom assessment

To use this tool:
You may print and copy this tool for your own use from this site. Please credit source.

Developed specifically for this project by the project team.

To view this tool:
Left click on the download link to view the PDF document in your Web browser. Right-click on the download link to save the document to your computer.
pdf PDF 182 KB / 4 pages (Viewing PDF files requires downloading and installation of the free Adobe Acrobat Reader.)

Posted April 2004

Cooper Green Hospital overview page

# BOG7, type:clinical_assessment

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 for more resources.

Promoting Excellence logo and link to home page