Department of Veteran's Affairs, West Los Angeles Medical Center - Pathways of Caring Program: Case Manager's Comprehensive Patient History and Initial Assessment
An intake interview covering general medical history, social history, nutrition, spiritual history, and psychological history of new patients.
Clinical Care Tools - Case Management
Veterans Affairs - The Greater Los Angeles Healthcare System
Veterans Integrated Palliative (VIP) Program
11301 Wilshire Boulevard, 111-G
Los Angeles, CA 90073
Phone: (310) 268 - 3500
Fax: (310) 268 - 4272
M. Jillisa Steckart, Psy.D.
How the grantee used this instrument:
This interview was used for all programs of Pathways at the time of intake, and for all patients enrolled in a program.
care coordination, care planning, 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 28 KB / 7 page (Viewing PDF files requires downloading and installation of the free Adobe Acrobat Reader.)
Posted October 2004
Department of Veteran's Affairs, West Los Angeles Medical Center overview page
# VA-WLA07, type:case_managment
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.