Surgical Discharge Summary Template
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Patient Information:
- Name / MRN:
- Procedure Performed:
- Surgeon:
- Date of Surgery:

Hospital Course:
- Indication & Key Events:
- Complications:
- Drain/Tubes at Discharge:

Medications at Discharge:
- Continue:
- New:
- Stopped:

Wound Care Instructions:

Activity Restrictions:

Dietary Guidance:

Follow-up Plan:
- Surgeon Visit:
- Primary Care:
- Therapy/Rehab:
- Pending Results:

Warning Signs & Return Precautions:

Equipment / Home Services:

Discharging Provider Signature & Credentials
Date / Time