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Discharge Medication Prescription Form


This form serves to update all prescriptions at the time of discharge, reconcile all existing and new medications, and inform patients of their medication instructions post-discharge. It contains information in a single place to coordinate the activities of prescribers, nurses, patients, and community pharmacists and reduce medication errors. 

Sections of the form include:
  • Current prescription and non-prescription medications
  • Controlled substances
  • Medications taken prior to admission to stop taking after discharge 
  • Instructions to all users of the form


Emory Healthcare

Funding Sources

Agency for Healthcare Research and Quality

QualityTool Topic



  • Release Date: 03/2007
  • Original Summary: 10/2008
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QualityTool Classification

Last updated: January 30, 2013.