Hospital Transfer Cover Sheet

Resource: Hospital Transfer Cover Sheet (PDF, 358 KB) 

This form is to be used by nursing home staff prior to patient transfer to the hospital. The completed form should travel with the resident to provide Emergency Department staff with essential information.

Source: Probari - for the IN DOH
Topic(s): Infection Control & Prevention; Patient-Centered Care
Audience(s): Clinicians
Format: PDF
Publication Date: 4/9/2020