Abstract Background: The Distress Thermometer (DT) is a simple and valid tool that should become the standard of care in the outpatient cancer setting to help clinicians better identify psychosocial distress at an early stage. The purpose of the project was to implement distress screening with the distress thermometer (DT) with problem list (PL) to screen and address distress symptoms in an adult outpatient cancer center. Method: The distress screening pivotal visit was incorporated into the patient’s care plan at on day 8 on the 3rd cycle of the patients’ chemotherapy regimen. Patients graded their level of distress on the DT and identified the sources of their distress using the PL. A pre and post visit survey was done and analyzed using descriptive statistics. Pre-test and post-test DT scores were compared using and paired t-tests. Results: A total of 83 patients received an initial distress pivotal visit and completed pre-test measures. Seventy-two completed post-test measures. Paired-t test indicated an average reduction in distress score SD 1.76 from an average baseline score of 4.1. Paired-t test score of 9.55 and P-value <0.0001, N =71. Of those who completed a post-test evaluation, 99% found the distress screening useful. Conclusions: Our results indicate that the DT is a simple and valid tool for measuring distress in this outpatient cancer setting. There are many validation studies supportive of this finding and encourage its use oncology clinics. However, further study may be warranted to assess long-term benefits of distress screening.