Discharge Instructions
- Patient's Name: ____________________________________
- Diagnosis: Your child's diagnosis is
____________________________
- Discharge Instructions:
- Additional Instructions:
- _______________________________________________________
- _______________________________________________________
- _______________________________________________________
- Follow-up Appointment after Discharge
___ Your child needs to be rechecked and has an
appointment on _____________ at _______ with
_________________________.
___ Your child needs to be rechecked in ________ days.
Call your child's doctor to make an appointment.
___ A follow-up appointment is not necessary. Call your
doctor if you have any concerns.
- Call your doctor if any of the following occur (phone:
: ___________)
- _______________________________________________________
- _______________________________________________________
- _______________________________________________________
- Caregiver's name __________________________
Date___________
Written by B.D. Schmitt, M.D., and Robert Brayden, M.D.
This content is reviewed periodically and is subject to
change as new health information becomes available. The
information is intended to inform and educate and is not a
replacement for medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
Copyright © 2006 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved.