Home
Against Medical Advice Note
Risks discussed
death
disability
prolonged hospitalization
prolonged illness
Benefits discussed
additional treatment
offering alternative options
Actions Taken
answered all of their questions about their condition
provided written discharge instructions which were reviewed
advised them to return to an emergency department
Specific Concerns
traumatic injuries
infection/sepsis
substance use
cardiac
neurologic
psychiatric
Diagnostics/Treatments Offered
observation
lab testing
imaging
IV fluids
antibiotics
admission
Risk Mitigation
outpatient follow-up
rx management
discussion with family
Capacity Evaluation
a & Ox3
gait
explained why
psychiatric
Copy to Clipboard
Clear