Skip to main content
mayologo1
  • Patient Online Services
  • Pay Bill Online
  • Request an Appointment
    • Services
    • Providers
    • Locations

      Minnesota

      • Adams
      • Albert Lea
      • Austin
      • Belle Plaine
      • Blooming Prairie
      • Butterfield
      • Caledonia
      • Cannon Falls
      • Fairmont
      • Faribault
      • Janesville
      • Kenyon
      • Lake City
      • Le Sueur
      • Mankato
      • Montgomery
      • New Prague
      • New Richland
      • Northfield
      • Owatonna
      • Plainview
      • Red Wing
      • Sherburn
      • St. James
      • St. Peter
      • Waseca
      • Waterville
      • Wells
      • Zumbrota

      Wisconsin

      • Arcadia
      • Barron
      • Bloomer
      • Chetek
      • Chippewa Falls
      • Eau Claire
      • Ellsworth
      • Glenwood City
      • Holmen
      • La Crosse
      • Menomonie
      • Mondovi
      • Onalaska
      • Osseo
      • Prairie du Chien
      • Rice Lake
      • Sparta
      • Tomah

      Iowa

      • Decorah
      • Lake Mills

      View map
    • Classes/Events
    • Blog
    • Wellness
    • Referrals
    • COVID-19
    • Home
    • About Us
    • Billing & Insurance
    • Careers
    • Patients & Visitors
    • Services & Treatments
    • Volunteer
    Need to contact us?
    • 800-679-9084

    Hospice

    • Overview
    • FAQs
    • Hospice Readiness Questionnaire
    • Bereavement & Grief Support
    • How You Can Help

    Hospice Readiness Questionnaire

    If you're not sure if hospice is right for you and your family, this brief questionnaire can help.

    Have you or your loved one:

    • Been hospitalized or gone to the emergency room several times in the past six months?
    • Been making more frequent phone calls to your physicians?
    • Started taking medication to lessen physical pain?
    • Started spending most of the day in a chair or bed?
    • Fallen several times over the past six months?

    Started needing help from others with:

    • Bathing
    • Dressing
    • Eating
    • Getting out of bed
    • Walking
    • Started feeling weaker or more tired?
    • Experienced weight loss making clothes noticeably looser?
    • Noticed a shortness of breath, even while resting?
    • Been told by a doctor that life expectancy is limited?

    If any of these apply, there's a good chance that hospice care is the right answer for you and your loved ones. Requesting hospice services can be made by the person needing hospice services, family, physician, clergy or social service agencies.


    Not all treatments, tests and services are available at all Mayo Clinic Health System locations. Check with your preferred location in advance.

    Stay Connected

    • Contact Us
    • Notice of Nondiscrimination
    • Notice of Privacy Practices
    • Terms of Use
    • Privacy Policy
    • About Us
    • Careers
    • Volunteer
    • Donate
    • For Patients & Visitors
    • Financial Assistance
    • Community Resources
    • Mayo Clinic Connect
    • For Medical Professionals
    • Press Room
    • Mayo Clinic
    • Home
    © 2018 - 2023 Mayo Clinic Health System