Week 8
cid:D7D4B297-EEAE-4174-AD01-F87097282051@canyon.com
Discharge Summary Template
Directions: Complete the Discharge Summary form by addressing the fields below.
Client Name: Date of Birth:
Date of Admission: Date of Discharge:
Presenting Problem Upon Admission:
Current Medication:
Reason for Discharge:
Case Manager Follow Up: <enter how you will follow-up with Eliza during treatment>
Resources & Referrals:
|
Eliza D 00/00/00 |
|
<sign and date here> |
|
Client Signature & Date |
Case Manager Signature & Date |
© 2015. Grand Canyon University. All Rights Reserved.
© 2015. Grand Canyon University. All Rights Reserved.