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Hospital Patient Release Form
"I need a Hospital Patient Release Form for an elderly patient being discharged to a care home after hip surgery, including specific provisions for physiotherapy follow-up and medication management for multiple chronic conditions."
1. Patient Information: Full name, date of birth, NHS number, contact details, and other identifying information
2. Admission Details: Date of admission, reason for admission, treating physician, and relevant medical history
3. Discharge Summary: Treatment received, current condition, reason for discharge, and medical status at discharge
4. Follow-up Care Instructions: Medication schedule, future appointments, care requirements, and recovery guidelines
5. Patient Acknowledgment: Patient's confirmation of understanding discharge instructions and consent to discharge
1. Mental Capacity Assessment: Assessment of patient's capacity to make decisions about their care and discharge, required for patients with cognitive impairment or mental health issues
2. Social Services Referral: Details of arranged social care support and community services for patients requiring ongoing social care
3. Transportation Arrangements: Specific arrangements for patient transport home or to care facility, including special requirements or assistance needed
1. Medication Schedule: Detailed list of prescribed medications, dosing instructions, and duration of treatment
2. Care Plan: Comprehensive post-discharge care requirements, instructions, and rehabilitation plan
3. Equipment List: Inventory of medical equipment provided or required for home care, including usage instructions
4. Emergency Contacts: List of healthcare providers, emergency contacts, and relevant support services
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