COVID-19 Case Report Form Created By PCQC

In the wake of the COVID-19 crisis, there has been a tremendous amount of uncertainty facing clinicians and administrators throughout our field. In response, the Palliative Care Quality Collaborative (PCQC) developed a short case report form to collate experiences of palliative care clinicians in caring for COVID-19 positive, PUI (Persons Under Investigation), and recovered patients. These experiences will be shared with the palliative care community to foster clarity in the field through continuous learning.

The case report is free to use and does not require you to become a member of the PCQC. We intend for the information collected to provide a benefit to the field.

For more information about the case report, including a pdf copy of the case report, visit the PCQC COVID-19 Case Report page.

To go directly to the case report, click here.

Please reach out to Lance Mueller with any questions or concerns at This email address is being protected from spambots. You need JavaScript enabled to view it.

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