Patient death- phone call summary:
Condolences offered? {formmenu: Yes; default=No\ ; name=Condolences offered}
If not then why?
Name of person calling?
Relationship to the patient? {formmenu: Spouse (married); default=Partner (not married); Child\ ; Sibling\ ; Parent\ ; Other\ ; name=Relationship to patient\ }
If other please explain:
Contact details taken {formmenu: Yes; default=No; name=Contact details}
What are the contact details?
Any other relevant information:
Have you informed AD{formmenu: Yes; default=No\ ; name=Informed AD?}