Clinical Indicators

Clinical Indicators for Providers

Minnesota Hospice wants to help make the transition to hospice care easy and stress-free for patients, families, and medical professionals. We understand determining hospice eligibility can be challenging. Our goal is to provide you with the clinical information you need regarding eligibility, along with a simple referral process, and forms at your fingertips, to ensure the best possible outcomes for your patients with advanced life-limiting illnesses and their loved ones.

Referral is Fast and Easy

Referral for Physicians and Nurse Practitioners

  1. Print out Physician Evaluation and Treatment Order under Forms.
  2. Fill-out Physician Evaluation and Treatment Order.
  3. Fax order to Minnesota Hospice at 952-898-4006.

If an emergency admission is required, please fax Physician Evaluation and Treatment Order and call our 24/7 main line at 952-898-1022.

Referral for Facilities

  1. Print out Fax Referral Form.
  2. Fill-out Fax Referral Form.
  3. Fax form to Minnesota Hospice at 952-898-4006.



  1. Call Minnesota Hospice 24/7 main line at 952-898-1022.

If an emergency admission is required, please fax the Fax Referral Form and call our 24/7 main line.

General Clinical Guidelines

Hospice-appropriate individuals may exhibit some or all the general indicators for disease progression. If 3 or more of these indicators are present, it may be time to refer to hospice.

Clinical Status




Additional Considerations

Disease-Specific Guidelines

Cancer Indicators

Alzheimer’s Disease and Dementia-Related Disorders Indicators

Cardiac Disease Indicators

HIV Indicators

Liver Disease Indicators

Neurological Disease Indicators (ALS/MS/Palsy/Parkinson’s)

Pulmonary Disease Indicators

Renal Disease Indicators (Chronic)

Stroke/Coma Indicators

About Us

All people deserve love, compassion, and dignity at end-of-life. At Minnesota Hospice, we strive to empower people to live life as fully as possible on their terms. Our team is filled with experienced professionals dedicated to walking with you during this part of life’s sacred journey. We provide the highest level of hospice care possible to help people find meaning, purpose, love, and beauty in living before departing life peacefully.

Contact Us For More Information or to Schedule a Complimentary Consultation

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“We do not remember days, we remember moments.”

Cesare Pavese

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