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Discharge Summary Template - Download Free Forms ... - TidyForms 2026

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The document outlines a suggested format for discharge summaries from Inova Fairfax Hospital's Department of Medicine. It includes sections for patient information, diagnoses, consultations, procedures, complications, a history of the hospital course, discharge plans, and follow-up issues. The example provided illustrates how to document a patient's admission and discharge details effectively, emphasizing a problem-oriented approach to summarizing clinical evaluations and treatments.

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Click ‘Get Form’ to open the Discharge Summary Template in our editor.
Begin by entering the patient's name, admission date, and discharge date in the designated fields. This information is crucial for accurate record-keeping.
Fill in the attending and dictating physician's names. Ensure these are correct as they will be referenced in follow-up communications.
Document the admitting and discharge diagnoses. Clearly state the principal diagnosis followed by any other relevant conditions addressed during the hospital stay.
In the consultations section, list any specialists involved in the patient's care. For procedures, provide a brief description of significant results.
Summarize the history and hospital course by outlining key clinical data and treatment outcomes for each problem identified.
Complete the discharge plan, detailing the patient's condition upon discharge, activity level, diet recommendations, next appointment details, and medications prescribed at discharge.

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