e18640 Background: Malnutrition occurs in 40-80% of cancer patients and has great impact on quality of life and treatment outcomes. The essential elements of malnutrition for patients with cancer are early identification of patients at greatest risk, nutrition assessment to determine the level of deficit, and appropriate nutrition intervention. Currently we don’t have a standard tool to identify patients who are malnourished on chemotherapy and nutrition referrals were placed based on provider's subjective assessment. Methods: From March 2020 to August 2020, 41 patients on chemotherapy were reviewed, of which 29% were referred to nutrition. To assess the patients at risk early on, a validated Malnutrition Screening Tool(MST) was implemented from September 2020 to February 2021 in the Medical Oncology fellow's clinic notes. Although the original MST was implemented mostly for inpatient elderly patient population, the idea of this study was to apply this tool to assess acute nutrition issues for patients receiving cancer therapy in the outpatient setting. This tool used two simple questions, Have you lost weight recently without trying? (If lost 1-6lbs = 1points, 7-13lbs = 2points and > 13 = 3points), and have you been eating poorly because of decreased appetite? (Yes = 1 point; No = 0 points).A smart phrase which included these questions was used in the notes and if patients scored greater than or equal to 2, were considered malnourished and qualified for nutrition referrals. Other variables included were age, sex, and type of cancer. Results: Of the 41 charts that implemented MST, 21 patients(49%) screened positive and all 100% of them were referred to nutrition. After implementing this tool, there was a 20% increase in identifying and referring the malnourished patients who were receiving cancer therapy during the clinic visits. Median age for patients who screened positive was 60 years, more males screened positive than females(60% vs 40%). Gastro-intestinal malignancies and head and neck cancers were the highest who screened positive in the MST group(14% each out of the 49%). Conclusions: Malnutrition is a major cause of morbidity and mortality in patients with any stage cancer and especially worse in advanced stage cancer. By simply using this two-step questionnaire, we were able to identify 20% more patients who were at risk for malnutrition. Older age, Males and Gastro-intestinal and Head and Neck cancer patients are more at risk and needs to be more closely screened. The study concludes that using a simple tool in the outpatient clinics can assess patient's at risk and provide early qualitative support throughout course of therapy.