Psychiatric Discharge Note Template
PATIENT NAME:
DATE OF BIRTH:
DATE OF ADMISSION:
DATE OF DISCHARGE:
DATE OF SERVICE:
IDENTIFYING INFORMATION:
ADMISSION LEGAL STATUS:
CHIEF COMPLAINT:
HISTORY OF PRESENT ILLNESS:
PAST PSYCHIATRIC HISTORY:
SUBSTANCE USE HISTORY:
OUTPATIENT MEDICATIONS:
OUTPATIENT PROVIDERS:
PAST MEDICAL HISTORY:
ALLERGIES:
PHYSICAL EXAMINATION:
SOCIAL HISTORY:
FAMILY PSYCHIATRIC HISTORY:
MENTAL STATUS EXAM ON ADMISSION:
HOSPITAL COURSE:
MENTAL STATUS EXAM ON DISCHARGE:
LABORATORY DATA:
DISCHARGE DIAGNOSES:
DISCHARGE PLAN:
MEDICATION CHANGES/ADDITIONS MADE DURING ADMISSION:
MEDICATIONS PRESCRIBED UPON DISCHARGE:
NOTE: More than 30 minutes was spent by the attending psychiatrist coordinating patient’s discharge from the unit.
Published on 4/13/2020. Copyright 2020 Inpatient Psychiatry Today.