---
title: Hospice Care Admission and Consent Form Template | Paperform
description: Professional hospice admission form template with treatment consent, DNR preferences, HIPAA authorization, pain management options, and end-of-life care documentation for compassionate patient enrollment.
url: "https://paperform.co/templates/hospice-care-admission-and-consent-form"
type: static
generatedAt: "2026-03-31T00:48:43.364Z"
---

[← Back to free form templates](/templates/)    ![Hospice Care Admission and Consent Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/hospice-care-admission-and-consent-form.png)
    [Preview](https://_preview.paperform.co/ai-template/hospice-care-admission-and-consent-form) [Use this template for free](/create?ai-template=hospice-care-admission-and-consent-form)    [Healthcare & Medical Forms](/templates/category/healthcare/)[Legal & Compliance Forms](/templates/category/legal/) [Healthcare](/templates/industry/healthcare/)[Senior Care](/templates/industry/senior-care/)[Hospice & Palliative Care](/templates/industry/hospice/) [Physician](/templates/role/physician/)[Nurse](/templates/role/nurse/)[Social Worker](/templates/role/social-worker/)[Healthcare Administrator](/templates/role/healthcare-admin/)[Caregiver](/templates/role/caregiver/)     About this free form template
### Compassionate Hospice Care Admission Made Simple

Transitioning to hospice care is a deeply personal and important decision that requires careful documentation and clear communication. This **Hospice Care Admission and Consent Form** template is designed specifically for hospice care providers, palliative care teams, and healthcare facilities that need to collect sensitive end-of-life preferences, treatment consent, and HIPAA authorizations in a respectful, organized manner.

#### Why Choose Paperform for Hospice Admissions?

When families and patients are navigating one of life's most challenging transitions, the last thing they need is confusing paperwork or impersonal digital forms. Paperform allows hospice care providers to create **compassionate, easy-to-read forms** that maintain dignity while collecting all necessary medical, legal, and care preference information.

This template replaces lengthy paper packets with a single, streamlined digital form that families can complete at their own pace—whether at the facility, from home, or on a mobile device. The professional yet warm design puts patients and families at ease during an emotionally difficult time.

#### What This Template Includes

This hospice admission form template covers all essential aspects of hospice enrollment:

 - **Patient and responsible party information** with emergency contacts
 - **Primary diagnosis and medical history** relevant to hospice care
 - **Physician and healthcare provider** details for care coordination
 - **Insurance and payment information** including Medicare/Medicaid details
 - **HIPAA authorization** for information sharing with designated individuals
 - **Treatment consent** for hospice services and palliative care
 - **DNR (Do Not Resuscitate) order preferences** and advance directives
 - **Pain management and symptom control** preferences
 - **End-of-life care wishes** including spiritual and cultural considerations
 - **Family notification authorization** for medical updates and emergencies
 - **Preferred place of care** (home, facility, hospital)
 - **Funeral arrangements and wishes** documentation
 - **Legal representative** and power of attorney information

The form uses conditional logic to show relevant follow-up questions based on patient responses, ensuring families only see fields that apply to their specific situation.

#### Built for Healthcare Compliance and Sensitivity

Hospice care documentation requires both legal precision and emotional intelligence. This template strikes that balance by:

 - Maintaining **clear, compassionate language** that families can easily understand during difficult times
 - Ensuring **HIPAA compliance** with proper authorization and consent sections
 - Collecting **legally required signatures** through integration with Papersign for secure eSignatures
 - Using **conditional fields** to avoid overwhelming families with unnecessary questions
 - Providing **comprehensive data capture** that meets regulatory and accreditation standards

The form is structured to align with hospice industry best practices and can be easily customized to meet your facility's specific protocols, state regulations, and organizational requirements.

#### Streamline Your Hospice Admissions Process

Traditional hospice admission involves multiple forms, physical signatures, and manual data entry that can take hours to process. This digital form template transforms that experience:

**For Families and Patients:**

 - Complete admission paperwork from the comfort of home before the first visit
 - Take breaks and return to the form as needed during emotional discussions
 - Avoid repetitive questions across multiple paper forms
 - Receive immediate confirmation that their preferences have been recorded

**For Hospice Care Teams:**

 - Receive complete, legible admission information instantly
 - Eliminate manual data entry and filing of paper forms
 - Automatically route completed forms to the right team members
 - Maintain organized digital records that are easy to access and update

#### Automate Your Hospice Workflow with Stepper

Once a family submits the hospice admission form, Paperform integrations with **Stepper** (stepper.io) can help you automate the entire care coordination process:

 - Automatically create patient records in your hospice management system
 - Notify the care team, social worker, chaplain, and nursing staff of new admissions
 - Generate welcome packets and care plan documents pre-filled with patient information
 - Schedule initial assessment visits and care team meetings
 - Add patient preferences to your EMR or patient management database
 - Send confirmation emails to family members with next steps and contact information
 - Trigger background verification and insurance eligibility checks

By connecting Paperform to your existing healthcare tools through Stepper, you can reduce administrative burden and ensure every new hospice patient receives prompt, coordinated care from day one.

#### Secure eSignatures with Papersign

Many hospice admission documents require signatures from patients, legal representatives, and witnesses. Rather than printing, signing, scanning, and filing paper forms, you can use **Papersign** (papersign.com) to:

 - Automatically generate signature-ready consent documents from form submissions
 - Send signature requests to patients, family members, and legal representatives
 - Collect legally binding eSignatures that meet healthcare documentation standards
 - Maintain a complete audit trail of who signed what and when
 - Store signed documents alongside the original form submission for easy reference

This paperless approach is especially valuable when family members are in different locations or when patients are receiving care at home.

#### Designed for Healthcare Professionals

This template is ideal for:

 - **Hospice care agencies** managing home-based and facility-based programs
 - **Palliative care teams** in hospitals and specialized care centers
 - **Nursing homes and assisted living facilities** with hospice partnerships
 - **Hospital discharge planners** coordinating transitions to hospice care
 - **Social workers and case managers** facilitating hospice enrollments
 - **Hospice medical directors and nurses** who need complete patient histories

Whether you're a small community hospice or a large healthcare system with multiple hospice programs, this template provides a professional foundation that can scale with your organization.

#### Customizable to Your Care Philosophy

Every hospice organization has its own approach to end-of-life care. This template is fully customizable through Paperform's intuitive editor, allowing you to:

 - Add your organization's logo, colors, and branding
 - Include specific questions about your facility's programs and services
 - Adjust language to reflect your care philosophy and values
 - Add fields for specialty services like music therapy, pet therapy, or bereavement support
 - Incorporate your state's specific legal requirements and forms
 - Translate the form into multiple languages for diverse communities

The flexibility of Paperform means you can create a hospice admission form that truly represents your organization's mission while maintaining the clinical rigor required for quality care.

#### Why Healthcare Providers Choose Paperform

Over 500,000 teams worldwide trust Paperform for their essential forms and workflows. Healthcare providers specifically appreciate:

 - **SOC 2 Type II compliance** ensuring enterprise-grade security for sensitive health information
 - **GDPR compliance** for organizations serving international patients
 - **Flexible data residency controls** to meet regional healthcare regulations
 - **Role-based permissions** so only authorized team members access patient information
 - **Integration with healthcare tools** including EMRs, CRMs, and communication platforms
 - **Mobile-responsive design** that works perfectly on tablets during bedside admissions
 - **Offline form completion** capabilities for areas with poor connectivity

While Paperform is not HIPAA compliant, it provides robust security features suitable for many healthcare administrative workflows. For organizations requiring HIPAA compliance, consult with your compliance officer about your specific use case.

#### Get Started in Minutes

This hospice care admission template is ready to use immediately. Simply customize the questions to match your facility's requirements, add your branding, and share the form with families beginning their hospice journey. You can embed it on your website, send it via email, or provide a direct link during enrollment conversations.

By digitizing your hospice admission process with Paperform, you're not just saving time—you're creating a more compassionate, organized experience for families during one of life's most meaningful transitions.

Start with this template today and transform how your hospice organization welcomes and cares for patients and their loved ones.
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