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Azalea Hospice
Azalea Hospice(903) 555-0000

Free Resource · For Families

Hospice Eligibility Worksheet

The same clinical criteria doctors use — PPS scale, the surprise question, ADL dependencies, disease-specific markers. Fill it out at home. Bring it to your loved one's next appointment.

Free resource · For families

Get the worksheet

Enter your email and we'll unlock the printable worksheet. We'll also send the occasional family-focused guide — no sales pitch.

What's inside

  • 8 sections covering the actual clinical criteria
  • Performance status (PPS) reference scale
  • ADL dependency checklist
  • Disease-specific indicators (6 common diagnoses)
  • Questions to ask the doctor — verbatim

We'll send you the resource and occasional family-focused guides. Unsubscribe any time. We never sell or share your information.

Accreditations & certifications

CMS

Medicare-Certified

CMS Provider · NPI #1700460789

TX

Texas-Licensed

DSHS HCSSA #020708

CHAP Accredited — Community Health Accreditation Partner

CHAP Accredited

Independent accreditation

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