The Palliative Care Outcome Scale

User Information and Registration Form

The Palliative Care Outcome Scale is copyright. However, you are free to use it, in full or as individual items, adapt it to your local circumstances or reproduce it without charge providing that you complete the following registration form and agree to the following conditions.

  1. Both The Palliative Care Outcome Scale and Professor Irene Higginson will be acknowledged in any publication, reports or oral presentations.
  2. If P.O.S. is copied for others you undertake to ensure they agree to the user registration form and return this to Professor Higginson.
  3. P.O.S. will not be sold, either in its original or adapted form.

I agree to the above conditions.

Name:
Address:

 
Telephone:
Fax:
 

 

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Signature of Applicant Date:

Location where you may use P.O.S. (please circle as appropriate)

Homecare / daycare / hospice / general practice / community nursing / oncology unit / hospital team / other (please specify) ___________________

Do you plan to use P.O.S. (please circle as appropriate)

yes definitely / possibly / not sure / no

Please return this form to:

Professor Irene Higginson, Dept of Palliative Care and Policy, GKT School of Medicine, New Medical School, Bessemer Road, LONDON SE5 9PJ. Tel: 020 7346 3995, Fax: 020 7346 3864.

[Go to Palliative Care Outcome Scale (Staff Questionnaire]
[Go to Palliative Care Outcome Scale (Patient Questionnaire]
[Go to Palliative Care Outcome Scale Scoring Sheet]