First-level Socio-Geriatric Assessment in times of Social Distancing

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Patient phone number
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Patient First Name
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Patient Last Name
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Contact First Name
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Contact Last name
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SCRIPT FOR PATIENT

Hello! I am .... from .... and I'm calling ..... Are you all right? If it's ok with you, we'd like to check on your health and I have a few questions for you. Are you willing to answer them?


SCRIPT FOR SPOUSE & OTHER

Hello! I am .... from .... and I'm calling .... Is everything all right? If you don't mind, we'd like to check up on Mr. and Mrs.'s health and I have a few questions for you. Are you the right person to answer them?


IF NO

These are very simple questions to make sure that you are healthy and safe, it won't take very long.

IF STILL NO

I understand completely, Sir/Madam. Thank you for your time and please know that we are at your disposal, do not hesitate to contact us at any time. Have a nice day!

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Write down the reasons invoked by this patient