Outpatient Discharge Form
Form Template
Please complete and submit the Outpatient Discharge Form mobile app for your
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mental health or substance abuse patient as soon as you confirm a Discharge Date. For example, if this is an unplanned, patient directed discharge, submit this form as soon as you are aware of the fact that your patient has discontinued using your services. The treating provider can document patient information, provider information, primary discharge diagnosis, type and reason for discharge and current impairments.
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