Hospital Discharge Handover Record

Who this is for

What you were told when somebody came out of hospital, on one page. It records the ward, who told you, what has changed, the follow-up appointments mentioned, any equipment due to arrive and who to ring if something goes wrong — written on the day, before the details blur.

Relatives and carers collecting somebody from hospital, families taking turns who were not all there to hear the discharge conversation, care agencies picking up a client after a stay, and anybody who got home and found nobody could remember what the nurse said.

What this helps you track

• Which ward, which hospital and who to ring back with a question
• What has changed, in the words you were given at the time
• Follow-up appointments with whom, when and where, and whether they are booked
• Equipment or services that are meant to arrive, and whether they have
• Who to ring if something goes wrong, so the number is on the sheet and not in a bag

How to use it

1. Fill in the top of the sheet before you leave the ward if you can: the date, the ward, the person who spoke to you and the number to ring back.
2. Write what has changed as it was described to you, in their words, and copy anything about medicines from the discharge paperwork rather than from memory.
3. List every follow-up appointment that was mentioned, and tick it once a date is actually confirmed.
4. Record anything that is supposed to arrive — equipment, a visit, a referral — with who is sending it and when they said.
5. Fill in the two lines for who to ring if something goes wrong, then leave the sheet where the next person to arrive will see it.
6. Keep it with the discharge letter; the sheet is your record of the conversation, and the letter is theirs.

Formats

• Printable PDF (A4 and US Letter)
• Fillable PDF with form fields
• Fill in online, saved in your browser

The printable is laid out inside a box that fits both A4 and US Letter, so the two files are identical and neither one is scaled. The fillable PDF has real form fields. The online version keeps what you enter in your own browser and builds the completed PDF on your device.

How to print

Download the A4 or US Letter file to match the paper in your printer, open it in a PDF reader and print at 100% — not "fit to page", which shrinks the writing space. Both files leave a 14 mm margin, which clears the unprintable edge on home printers. To print the online version with your entries in it, use the Print this sheet button, which prints only the sheet and none of the page around it. More on printing.

Questions

Does this replace the discharge letter?

No. The letter is the hospital's record and belongs with the person's papers. This sheet is the family's record of what was said and what was promised, which is usually more than the letter contains and rarely written down anywhere else.

Should I write medicine changes on it?

Copy what the discharge paperwork says, word for word, and nothing else. The sheet supplies no medicine names, no amounts and no timings of its own, and it does not interpret what the paperwork means — that is a question for the pharmacist or prescriber whose number you write on the who-to-ring lines.

What if nobody told us anything?

Write that down, with the date, and use the who-to-ring lines for the ward number so that somebody can ask. A sheet that says what was not explained is as useful as one that says what was.

Who should fill it in?

Whoever was in the room. If two people were, fill it in together on the way home; accounts of the same conversation differ more than anyone expects.

Can a care agency use it?

Yes. It is the sheet a carer arriving the next morning wants to read first, and the one that tells them which appointments are coming and what is due to arrive.