NPTF PATIENT TRANSFER NOTE

CAUTION: This page needs to be reviewed and categorized.
NPTF PATIENT TRANSFER NOTE
For transfers between VALBHCS services (to a new primary    team)
Not for transfers to outside facilities
To be completed by team sending transfer prior to transfer
Team accepting transfer should write a separate transfer accept note
 
 
TRANSFER FROM (service):  

TRANSFER TO (service): 

DATE OF TRANSFER: 
 
REASON FOR TRANSFER: 
-    Higher level of care
-    Lower level of care
-    Continued care under different service
-    Back to prior unit
 
 
Provided verbal sign-out to next primary team:    
Agreed - Proceed

Name of provider given verbal sign-out: 
 
 
HOSPITAL COURSE: 

Provide summary of major events of current hospitalization,including procedures. Do not just copy the assessment and plan.)
 
 
CURRENT MEDICATIONS:

VITALS:
 
PHYSICAL EXAM:
 
ACTIVE PROBLEM LIST AND PLAN:
 
 
SPECIFIC INSTRUCTIONS OR PRECAUTIONS FOR NEXT TEAM:
 
 
NPTF PATIENT TRANSFER NOTE
For transfers between VALBHCS services (to a new primary team)
Not for transfers to outside facilities
To be completed by team sending transfer prior to transfer
Team accepting transfer should write a separate transfer accept note


TRANSFER FROM (service):

TRANSFER TO (service):

DATE OF TRANSFER:

REASON FOR TRANSFER:
- Higher level of care
- Lower level of care
- Continued care under different service
- Back to prior unit


Provided verbal sign-out to next primary team:
Agreed - Proceed

Name of provider given verbal sign-out:


HOSPITAL COURSE:

Provide summary of major events of current hospitalization,including procedures. Do not just copy the assessment and plan.)


CURRENT MEDICATIONS:

VITALS:

PHYSICAL EXAM:

ACTIVE PROBLEM LIST AND PLAN:


SPECIFIC INSTRUCTIONS OR PRECAUTIONS FOR NEXT TEAM:


Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0, 126 boilerplate words
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