Get the free Child and Adolescent Discharge Form

This form is used for discharging a child/adolescent/caregiver when they are not present or participating in an Outcome Measurement System (OMS) interview. It includes sections on living situation,

How to fill out child and adolescent discharge

How to fill out Child and Adolescent Discharge Form

1. Obtain the Child and Adolescent Discharge Form from the healthcare provider or facility.
2. Fill out the patient's personal information, including their name, date of birth, and identification number.
3. Include details of the discharge date and time.
4. Provide the reason for discharge, including the patient's medical condition and treatment summary.
5. Document any follow-up appointments or referrals that are necessary.
6. List any prescribed medications the patient should take after discharge.
7. Gather contact information for responsible caretakers or guardians.
8. Review the completed form for accuracy and completeness before submission.
9. Sign and date the form as required.

Who needs Child and Adolescent Discharge Form?

1. The Child and Adolescent Discharge Form is needed by healthcare providers who are discharging a child or adolescent from a medical facility.
2. Parents or guardians of the patient who need a record of the child's treatment and follow-up care.
3. Mental health professionals involved in the patient's aftercare.
4. Schools or educational institutions that may require documentation of the child's health status.

For pdfFiller’s FAQs

What is Child and Adolescent Discharge Form?

The Child and Adolescent Discharge Form is a document used to record the details of a child's or adolescent's discharge from a healthcare or mental health facility, summarizing their treatment and progress.

Who is required to file Child and Adolescent Discharge Form?

Healthcare providers or facilities that have provided treatment to the child or adolescent are required to file the Child and Adolescent Discharge Form.

How to fill out Child and Adolescent Discharge Form?

To fill out the Child and Adolescent Discharge Form, the discharge planner or clinician should complete the form by entering the patient's details, treatment history, outcomes, and any follow-up recommendations.

What is the purpose of Child and Adolescent Discharge Form?

The purpose of the Child and Adolescent Discharge Form is to document the patient's treatment journey, facilitate communication with ongoing care providers, and ensure continuity of care after discharge.

What information must be reported on Child and Adolescent Discharge Form?

The Child and Adolescent Discharge Form must report information such as patient identification details, treatment summary, discharge diagnosis, medications prescribed, follow-up care instructions, and any referrals to other services.