Patient Handoff Form

Enhance patient safety during care transitions with this detailed Patient Handoff Form, designed to standardize communication between healthcare providers during shift changes and unit transfers.

• Patient Identification – Name, MRN, DOB, location
• Transfer Reason – Purpose and originating unit
• Critical Alerts – Allergies, fall risks, code status
• Vital Systems – Respiratory, cardiac, neuro status
• Physical Assessment – GI/GU function, skin condition
• Medical Devices – IVs, drains, catheters, oxygen
• Medication Summary – Current drugs and schedules
• Recent Interventions – Procedures, tests, results
• Psychosocial Factors – Family dynamics, support needs
• Safety Plan – Precautions, restrictions
• Care Priorities – Immediate action items
• Special Notes – Provider-specific instructions
• Communication Log – Family updates given

Ideal for nurses, physicians, and healthcare teams in hospitals, long-term care, and EMS who need to maintain continuity of care while reducing medical errors during patient handoffs.