Patient handover document

Print this and bring it to the clinic on discharge day. Patient sections you fill yourself; clinic sections the operating clinician fills. Take the completed form back to your home GP / PCP at your first follow-up.

Reference only — not medical advice. See disclaimer.

Patient sections

Fill these yourself before discharge.

Patient name

Date of birth

Home GP / PCP name + clinic

Known allergies

Existing home medications

Clinic sections

The operating clinician fills these on discharge day.

Clinic name

Country

Operating surgeon (full registered name)

Procedure performed

Surgery date

Emergency contact (24/7)

Operative summary

Implant / device details (brand, model, serial, batch)

Prescriptions (generic name, dose, duration)

Follow-up plan