San Francisco VA Health Care System
My discharge day is ____________________
My discharge time is ____________________
□ Did I arrange for a ride home?
□ Does my ride know when to pick me up?
□ Do I have all my medications and medical equipment or supplies I will need at home?
□ Do I have any clothing or items in the Patients Effects Room or with the Agent Cashier?
□ If I am going to need assistance after I get home, have I made arrangements with family or friends?
□ If the doctor ordered home care, do I know how to contact the agency?
□ If I will need home oxygen therapy, have arrangements been made?
□ Will I need to return to the VA to see my doctor? If so, have I been given my appointment?
□ Do I know how to take my medications?
□ Do I have a copy of my Discharge Instructions?