OTHER IMPORTANT INFORMATION
NOTES
Supplies / Equipment
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n What special supplies or equipment might I need?_________________________________________________
n Do I have what I will need?______________________________________________________________________
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n How do I get more supplies if I need them?________________________________________________________
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n What is the number?____________________________________________________________________________
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Home Health / Hospice
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n If I will be using home health or hospice, what agency will I be using?_________________________________
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n How do I contact the agency?___________________________________________________________________
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n When will they be coming to see me?_____________________________________________________________
n What will they help me with?_____________________________________________________________________
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NOTES
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