Discharge Summary Template
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Patient Information:
- Name:
- MRN:
- Admission Date:
- Discharge Date:

Attending Physician:
Primary Diagnosis:
Secondary Diagnoses:

Hospital Course Summary:
- Reason for Admission:
- Key Diagnostic Findings:
- Therapeutic Interventions:
- Response to Treatment:

Procedures Performed:

Medications at Discharge:
- Continue:
- New:
- Discontinued:

Follow-up Plan:
- Appointments:
- Pending Tests:
- Specialist Referrals:

Patient Instructions:
- Activity:
- Diet:
- Warning Signs:
- Home Services:

Disposition:

Discharging Provider Signature & Credentials
Date / Time