Psychiatric Facility Discharge Summary

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Glueckert Date Hospital Administrator // Thomas Gray, MD Date Medical Director MONTANA STATE HOSPITAL FORENSIC MENTAL HEALTH FACILITY DISCHARGE SUMMARY (Date here) MSH No: Date of Admission: Date of Separation: History of Present Illness: Psychiatric History: Drug and Alcohol History: Family History: Medical History: Social History: Work History: Marital History/Children: Military Service: Criminal History: Living Situation: Significant Medical and/or Physical Findings: Laboratory, X-ray Other Consultation Findings: Course in the Hospital: Condition at Discharge: Level of Risk at Discharge: Discharge Plan Disposition and Treatment Recommendations: Legal Status at Discharge: Discharge Instructions: Discharge Medications: Diagnoses: Primary: 2..

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