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Forms 2017-05-09T10:34:09+00:00
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Referral Form

To refer to our outpatient community-based palliative care team: Fax to 707-442-2006.
Before you send a referral, it is best to have had a conversation about palliative care with the patient being referred.
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California POLST Form

Physician Orders for Life-Sustaining Treatment (POLST) form for California.
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California Advance Health Care Directive Form

This form lets you have a say about how you want to be treated if you get very sick.
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