Discharge Medication Reconciliation Checklist
Patient Name:
MRN:
Date:
Medication List
Medication Name
Dosage
Route
Frequency
Continue/Discontinue/Change
Notes
Checklist
All discharge medications reviewed and reconciled
All medication changes (additions, discontinuations, dose/frequency/route changes) documented
Discrepancies clarified with provider as needed
Patient/caregiver received education on all discharge medications
Prescription(s) provided/arranged as needed
Follow-up plan communicated (provider, pharmacy, etc.)
Comments/Notes
Completed by:
Signature:
Date/Time: