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Consult Request Guidelines
for Palliative Care
Palliative Care
Suggested Pre-Referral Evaluation and Management Guidelines
Chronic Progressive Illness
Limited prognosis
Age over 18
Suggested Additional Test/Management Prior to Specialty Visit
It is helpful to discuss the rationale behind the palliative care consult, so patient and family are aware of the prognosis
Patient Education/Information (includes preps)
Interdisciplinary Assessment
Pain Control
Symptom Management
Caregiver support
Goals of Care
Referrals to hospice
Appointment Timeframe
2 weeks
How to Get Results to Consultant
UMHS Patients: See MiChart
External Patients: Patients hand carry outside records to visit
Clinic Contact Information
Physician: 800-962-3555
Patient: 734-764-6831
Clinic Location Sites
East Ann Arbor Health and Geriatrics Center
UM Consulting Physician
Caroline Anne Vitale, M.D.
Geriatrics Faculty
Revised on:
09/06/2012