Free printable hospital and discharge sheet (PDF)
What to say and ask before you let the hospital discharge them.
A hospital can pressure you, but it cannot make you pick someone up. The sheet gives you the words to use and the checklist for before you leave.
Open it on your phone and fill it in now.
Print it and write by hand, or fill it in on your computer and save it.
Need just the say-this lines? The hospital scripts card is one page.
Example pagesAn example page so you can see how it works.
What’s inside
- Page 1Who to ask for
- Page 2How the machine works
- Page 3Before you sign anything
- Page 4The stay, and the first three days home
En español
La misma hoja, en español. Imprímala y complete a mano, o llénela en la computadora y guárdela.
Questions
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What’s the catch?
There is none. It’s a free PDF, no email required, and we won’t follow up with anything. If it’s useful to you, share it with someone else who needs it.
Can I use it on my phone or computer?
You can use both. You might just need to install a free PDF viewer on your phone.
What if I don't have a printer?
You can fill it in on your computer using a PDF app and save it. Libraries and pharmacies have print counters if you need a paper copy later.
- The free caregiver binder puts the information in one place.
- "Is it really time?" is for deciding if it's time for a facility.
- "Who pays for what" covers the programs that help with costs.
You can photocopy this sheet and hand it out.
Medicare rules, forms, and phone numbers change. Checked July 2026. Before you lean on anything here, check medicare.gov or call 1-800-MEDICARE. We're caregivers, not lawyers or doctors.
