hospital discharge checklist template

Before bringing a loved one home please complete this checklist.

Discharge Discharge
  • Safety – Is your home a safe place for your recovery?

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  • Transportation – How will you get home from the hospital?

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  • Food – Do you have food and other necessities at home?

    ×

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  • Medication – Do you have all the medications you’ll need?

    ×

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  • Doctor’s Appointments – What is your follow-up care?

    ×

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  • Home Health Care – Are you eligible?

    ×

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  • Equipment – Do you need any medical equipment at home?

    ×

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  • Daily Routines – What changes or adjustments will you need to make?

    ×

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  • Household chores – Will you need help with cooking, cleaning, or laundry?

    ×

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  • Care Management – Will you need assistance managing your care?

    ×

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