Free Patient Discharge Summary Fax Sheet Template
Patient Discharge Summary Fax Sheet
FAX |
To: [RECIPIENT'S NAME]
Address: [RECIPIENT'S ADDRESS]
Date: January 20, 2055
Re: Patient Discharge Summary for [Patient's Name]
Fax no.: 123-456-7890
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Urgent
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For Review
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Please Respond
Message
Dear [RECIPIENT'S NAME],
Please find attached the discharge summary for the patient listed below. We kindly request transmission of this document to facilitate continuity of care between healthcare facilities and post-acute care providers.
Patient Information:
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Name: [Patient's Full Name]
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Date of Birth: [Patient's Date of Birth]
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Diagnosis: [Brief Description of Diagnosis]
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Discharge Date: [Date of Discharge]
Key Discharge Information:
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Summary of Hospital Course
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Procedures and Treatments Received
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Medication Reconciliation
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Follow-up Recommendations
Please ensure the secure and prompt delivery of this discharge summary to the designated recipient at your facility. If you require any additional information or assistance, please do not hesitate to contact our office at [YOUR COMPANY NUMBER]. Thank you for your cooperation in ensuring the continuity of care for our patients.
Kind Regards,
[YOUR NAME]
[YOUR DESIGNATION]
[YOUR COMPANY NAME]
