Get Acute Stroke Transfer Hand-off Communication Form

The Acute Stroke Transfer Hand-off Communication Form is an essential document for ensuring effective communication during the transfer of stroke patients. This guide provides step-by-step instructions for filling out the form online, catering to users of all experience levels.

Follow the steps to complete the form efficiently.

1. Press the ‘Get Form’ button to access the form and open it in your preferred editor.
2. Begin by entering the date and time of the transfer at the top of the form. Be sure to provide accurate information to maintain effective communication.
3. Complete the patient's name and date of birth in the designated fields. This information is vital for identifying the patient accurately.
4. In the 'Symptom Timeline' section, indicate the last time the patient was known to be well, along with the time of onset. Document the presenting symptoms and the initial NIHSS score as recorded upon arrival.
5. Specify whether a CT head scan was completed. If applicable, choose the correct interpretation from the provided options concerning hemorrhage.
6. Attach any recent history and physical exam if available. Indicate if the recent medication list is also attached to provide comprehensive medication history.
7. Review the contraindications for thrombolytics and check the relevant boxes for any that may apply to the patient. It is essential to consider these carefully for the patient’s safety.
8. Finally, have the referring physician sign and date the form at the bottom. This signature confirms the information provided and facilitates proper transfer.

Complete and submit your Acute Stroke Transfer Hand-off Communication Form online to ensure timely communication and care.