Hospital discharge forms are critical for ensuring seamless patient transitions, accurate record-keeping, and compliance with healthcare regulations.
Many healthcare providers and individuals search for reliable hospital discharge forms template options, often encountering PDF formats or paid services.
That’s why we’ve designed a 100% free, fully editable Hospital Discharge Form Template in Google Docs—tailored for hospitals, clinics, and healthcare providers who need flexibility without compromising quality.
Also see: Free Editable Doctor’s Note Templates That Look 100% Authentic
Why Use This Hospital Discharge Form Template?
✅ 100% Free & Accessible
Say goodbye to paid PDF downloads! Our template is completely free and accessible via Google Docs, allowing instant edits, updates, and collaboration.
✅ Fully Customizable
Adapt the form to your facility’s needs. Add logos, adjust fields, or include facility-specific protocols—no design skills required.
✅ Optimized for Compliance
Includes sections for ICD-10 codes, disposition details, insurance information, and provider credentials to meet healthcare standards.
✅ Time-Saving Structure
Pre-formatted sections like Patient Information, Admission Details, and Provider Information ensure no critical data is overlooked.
Key Sections in Our Hospital Discharge Form Template
Our template includes all necessary fields for a complete hospital discharge summary:
1. Sender/Caller Information
- Patient Name, Hospital Name, Provider Details
- Contact Information (Phone, Fax)
- Insurance Information
2. Patient Information
- Full Name & Date of Birth
- Health Insurance ID
- Gender
3. Admission & Discharge Details
- Admission & Discharge Dates
- Discharge Disposition (e.g., Home, Nursing Home Transfer, Other Hospital Transfer)
- Admission Source (ER, Direct, Scheduled, Transferred)
4. Bed & Unit Type
- Med/Surg, ICU, Mental Health, Pediatric, Maternity, NICU
- Delivery & Newborn Information (Twins, Triplets, etc.)
- ICD-10 Diagnosis & Procedure Codes
5. Provider Information
- Facility & Attending Physician Details
- Contact Information (Phone, Fax, Address, Tax ID)
Free Hospital Discharge Form Template
To get the template, simply click the “Get This Template” button below. You’ll be directed to the template preview page—ensure you’re logged into your Google Account. Once there, preview the template and click “USE TEMPLATE” to make a copy. You can then edit it as needed and print it when you’re ready.
Frequently Asked Questions (FAQs)
What’s included in a hospital discharge form?
Our template covers patient demographics, admission/discharge dates, disposition, ICD-10 codes, provider details, and insurance information.
Can I add my hospital’s logo?
Yes! The Google Docs format allows easy branding adjustments.
Is this template legally compliant?
While designed to meet general healthcare standards, always consult your legal team to ensure compliance with local regulations.
How is this different from PDF templates?
Unlike static PDFs, our Google Docs template lets you edit, duplicate, and share effortlessly—no software needed.
Conclusion
Our free, editable hospital discharge form template makes documentation simple, accessible, and efficient.
With easy customization in Google Docs, you can tailor it to your needs without the hassle of locked PDFs or paid downloads.
Click “Get This Template” now to streamline your hospital discharge process and ensure accurate record-keeping.