Hospital Patient Discharge Letter Template

You can open the Hospital Patient Discharge Letter Template in multiple formats, including PDF, Word, and Google Docs.

Open Template

Sample

Hospital Patient Discharge Letter Template

Printable | Editable Form

PDF 1 PDF 2

Examples

Hospital Patient Discharge Letter Template (1)
Patient Information:
[Patient’s Full Name]
[Patient’s ID Number]
[Date of Birth]
[Patient’s Address]
[Patient’s Phone Number]
Discharge Date:
[Discharge Date]
Healthcare Provider:
[Provider’s Name]
[Provider’s Title]
[Hospital Name]
[Hospital Address]
Reason for Discharge:
The patient is being discharged after treatment for [specific condition or procedure]. All necessary care has been provided, and the patient is stable for discharge.
Summary of Treatment:
During the hospitalization, the patient received the following treatments:
[List of treatments and procedures performed].
Follow-up Care:
The patient is advised to follow up with [Name of the Specialist] at [Clinic/Hospital Name] on [Follow-up Date].
Medications:
The patient is prescribed the following medications:
1. [Medication Name] – [Dosage and Instructions]
2. [Medication Name] – [Dosage and Instructions]
Patient Instructions:
– [Instruction 1]
– [Instruction 2]
– [Instruction 3]
Emergency Contact:
In case of any complications, please contact [Emergency Contact Name] at [Contact Number].
Signed in [City], [Date].
Sincerely,
[Signature of the Discharging Physician]
[Name of the Discharging Physician]
[Title]
[Contact Information]
Hospital Patient Discharge Letter Template (2)
Patient Information:
[Patient’s Full Name]
[Patient’s ID Number]
[Date of Birth]
[Patient’s Address]
[Patient’s Phone Number]
Discharge Date:
[Discharge Date]
Healthcare Facility:
[Facility Name]
[Address]
[Phone Number]
Diagnosis:
The patient was admitted with a diagnosis of [Diagnosis] and has responded well to treatment.
Care and Treatment Summary:
During the stay, the patient underwent the following treatments:
[Detail treatment course and progress].
Continuing Care Recommendations:
The patient is recommended to adhere to the following follow-up schedule:
– [Follow-up Appointment]
– [Additional Recommendations]
Medications upon Discharge:
The patient is to continue with the following medications:
1. [Medication Name] – [Dosage and Administration]
2. [Medication Name] – [Dosage and Administration]
Instructions for Home Care:
1. [Instruction 1]
2. [Instruction 2]
3. [Instruction 3]
Emergency Contacts:
For any questions or issues after discharge, please contact [Contact Name] at [Contact Number].
Signed in [City], [Date].
Sincerely,
[Signature of the Attending Physician]
[Name of the Attending Physician]
[Title]
[Contact Information]

Template Online

Format

Please complete the form below to create the Hospital Patient Discharge Letter Template. All fields must be filled out to ensure a clear and comprehensive discharge letter. We provide examples to guide you through each step.

Hospital Patient Discharge Letter Template

1. Patient Information


2. Hospital Information


3. Discharge Date

4. Medical Summary

5. Treatment Provided

6. Follow-Up Care Instructions

7. Medications Prescribed

8. Patient Responsibilities

9. Acknowledgment of Discharge



PDF

WORD

Google Docs

Printable

Hospital Patient Discharge Letter Template

Printable | Editable Form

PDF 1 PDF 2

Hospital Patient Discharge Letter Template