Background: The need for outpatient based palliative care in community cancer clinics has been repeatedly identified, but poorly integrated. Cancer patients benefit from focused attention on the alleviation of symptoms related to either disease or treatment. Methods: A pilot program was developed for use in the outpatient community cancer clinic setting. This program sought to determine feasibility in this setting. It was limited to one medical oncologist and one palliative care APRN. Modifications were made in the electronic medical record to accommodate scheduling, documentation on a palliative care specific progress note and billing. Complete palliative care assessment included: symptom burden assessment, distress analysis using ESAS tool, 10 system physical exam, social, spiritual and emotional history and assessments. Ancillary services of chaplaincy and social services were also available. Home palliative care services were provided by a palliative care accredited home health agency. Initial consult visits were billed 99215, lasting 60 minutes. Follow up visits were billed 99214, lasting 30 min. Family conferences, with the patient present, were billed at the 99215. Results: Sample size was 44 patients: 23% pancreatic cancer, 13% upper gastrointestinal cancers, 13% lung cancer, 11% prostate cancer, 6% each colorectal, ovarian, and hematologic malignancies. The sample size was smaller than anticipated as not all eligible patients were referred. Reports from patients, families, and medical providers were all positive. Conclusions: The program will now be expanded to the entire San Luis Obispo Oncology and Hematology health clinic. This will include five medical oncologist and four advanced practice providers as referral sources. It is anticipated that at least one full time palliative care APRN will be needed. The model was found to be feasible with the additional support of a chaplin, clinic social services, and home health palliative care. The goal is to reduce symptom burden and improve quality of life.