Hospice Quiz Has the patient experienced weight loss causing clothes to feel more loose? Yes No Has the patient been recently hospitalized? Yes No Has the patient had more than 1 fall in the past 6 months? Yes No Has the patient noticed shortness of breath, even when resting? Yes No Has the patient been making more frequent visits to the doctor? Yes No Name(Required) First Last Phone(Required)Email(Required) Enter Email Confirm Email City, State(Required) Your Message Δ