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TRANSFER OF CARE
The following protocols shall be used in all MS HSL section and state tournaments. With
MS HSL or section approval the medical professionals from participating schools may assist
with
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How to fill out transfer of care form

How to fill out transfer of care form
01
Start by obtaining a blank transfer of care form either in physical or electronic format.
02
Fill out the patient's personal information, including their full name, date of birth, and contact details.
03
Provide information about the transferring healthcare facility, such as its name, address, and contact information.
04
Mention the date and time of the transfer.
05
Clearly state the reason for the transfer and include any relevant medical diagnoses or conditions.
06
Include a summary of the patient's medical history and current treatment.
07
Specify any allergies, medications, or ongoing therapies that the patient is receiving.
08
If applicable, provide details about any medical equipment or devices that the patient requires.
09
If transferring to another healthcare provider, provide their name, address, and contact information.
10
Review the completed form for accuracy and ensure that all necessary details have been included.
11
Sign the form and date it.
12
Submit the form to the appropriate healthcare authorities or personnel as instructed.
Who needs transfer of care form?
01
The transfer of care form is usually needed for any patient who is transitioning from one healthcare facility to another.
02
This may include:
03
- Patients being transferred from a hospital to a rehabilitation center.
04
- Patients being transferred from one hospital to another for specialized treatment.
05
- Patients being transferred from a primary care physician to a specialist.
06
- Patients being transferred from a long-term care facility to a hospital for further medical care.
07
- Patients being transferred from an emergency room to a hospital for admission.
08
- Patients being discharged from a hospital to receive home healthcare services.
09
Essentially, anyone whose care or treatment is being transferred or handed off to another healthcare provider or facility may require a transfer of care form.
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What is transfer of care form?
Transfer of care form is a document used to transfer responsibility of a patient from one healthcare provider to another.
Who is required to file transfer of care form?
Healthcare providers involved in the care of a patient are required to file transfer of care form.
How to fill out transfer of care form?
Transfer of care form can be filled out by providing patient's information, current treatment plan, and reason for transfer.
What is the purpose of transfer of care form?
The purpose of transfer of care form is to ensure a smooth transition of patient care between healthcare providers.
What information must be reported on transfer of care form?
Patient's personal information, medical history, current medications, treatment plan, and reason for transfer must be reported on transfer of care form.
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