Patient Safety Tool: Patient Discharge Planning Checklist From CMS

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CMS has developed a free, downloadable discharge planning checklist for patients preparing to leave a hospital or other healthcare setting.


"Your Discharge Planning Checklist" is a six-page pamphlet which asks patients to answer more than a dozen questions including:


The pamphlet also allocates a space for noting medications and upcoming appointments.


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Download the patient discharge planning checklist (pdf) for use in your facility.


Note: View our database providing 90-plus reports that link to free, downloadable and adaptable tools for use in surgery centers, hospitals and other organizations by clicking here.


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