Transcription of Speech/Language Pathology Discharge Summary
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Speech/Language Pathology Discharge Summary
Caring for Your Quality of Life SLP Discharge Summary Page 1 of 1 Revised: 03/2012 Speech/Language PathologyDischarge Summary Patient s Last Name First Name MI HICN: Certification Period From: Through: # of Visits (Including Eval) Date of Discharge Summary of Progress (Provide objective measurements that directly relate to the LTGs established in the POT) LTG #1 Met Admission Status: Discharge Status: LTG #2 Met Admission Status: Discharge Status: LTG #3 Met Admission Status: Discharge Status: LTG #4 Met Admission Status: Discharge Status: LTG #5 Met Admission Status: Discharge Status: Reason for Discharge (Check all that apply): The patient has achieved the goals established at admission.
”Caring for Your Quality of Life” SLP Discharge Summary Page 1 of 1 Revised: 03/2012
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