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Mental Health Discharge Summary Sample.pdf Free Download Here SAMPLE INITIAL EVALUATION TEMPLATE Aetna http://www.aetna.com/healthcareprofessionals/documentsforms/BHTRRSampleTreatmentForms.pdf SAMPLE.

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6 Components of a Hospital Discharge Summary Reason for hospitalization: description of the patient's primary presenting condition; and/or. ... Significant findings: ... Procedures and treatment provided: ... Patient's discharge condition: ... Patient and family instructions (as appropriate): ... Attending physician's signature:

Creating a Discharge Summary in a client's profile Navigate to the client's Overview page. Click New>Assessment. Select Discharge Summary Note.

Example: “We have discharged Mrs Smith on regular oral (40mg OD) and we have requested an outpatient ultrasound of her renal tract which will be performed in the next few weeks. We will review Mrs Smith in the Cardiology Outpatient Clinic in 6 weeks time.

To continue to paraphrase the APTA's description: All discharge summaries should include patient response to treatment at the time of discharge and any follow-up plan, including recommendations and instructions regarding the home program if there is one, equipment provided, and so on.

What is in the discharge summary? Diagnosis at discharge. Detailed reasons for reasons for discharge (including progress toward treatment goals) Any risk factors at the time care ended. Referrals and resources of benefit to the client.

The discharge report must give a summary of everything the patient went through during the hospital admission period – physical findings, laboratory results, radiographic studies and so on.

The discharge summary is essentially the last opportunity the therapist has to justify the medical necessity of the treatments that were rendered during this episode of care. Therefore, additional relevant information may also be included in the report at the discretion of the therapist.

Ideally, this document should take no more than a few minutes for the receiving practitioner to review and ascertain the salient details of the hospitalization. In conveying this information, it can be helpful to think of the discharge summary as an admission H & P.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232