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AMA DISCHARGE

AMA DISCHARGE:
1. Reason: The patient has decided to leave against medical advice because .
2. Capacity: The patient has normal mental status and adequate capacity to make medical decisions.
3. Refusal: The patient refuses hospital admission and wants to be discharged.
4. Risks: Risks have been explained including  , worsening illness, permanent disability and death.
5. Benefits: Benefits of admission have also been explained
6. Understanding: The patient verbalized understanding the risks and benefits of hospital admission.
7. Witnesses: Nurse  and family  .
8. Questions: The patient had the opportunity to ask questions about their medical condition.
9. Plan B: The patient was treated to the extent they allow and knows they may return at any time
10. Follow-up: If possible the patient’s PCP was called to help try to convince them to stay in the hospital and to arrange appropriate follow-up care.

from emresource.org

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