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How to fill discharge form for patient 2011-2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by filling out the MEMBER/FACILITY INFORMATION section. Enter the member's name, contract number, phone number, and admission date. Ensure all information is legible.
  3. In the CLINICAL INFORMATION/BASICS section, provide vital signs and medical history. Include details about bowel and bladder function, as well as any surgical procedures that have occurred.
  4. Complete the MOBILITY CURRENT FUNCTIONING section by indicating the level of assistance required for various activities such as transfers and gait. Be specific about assistive devices used.
  5. Fill out the DISCHARGE (DC) PLANS section with tentative discharge dates and home evaluation details. Specify any equipment needed and supervision requirements.

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