Institute of Psychiatry, 1 North Department of Psychiatry and Behavioral Sciences Medical University Of South Carolina 67 President Street, P.O. Box 250861 Charleston, SC 29425 Total # of pages faxed, including cover: Inpatient Telephone: 843-792-0100 Inpatient Fax: 843-792-0113 FAX COVER SHEET — Brief Discharge Summary Date: To: Agency Fax Number Phone Number From: 1 North Adult Unit Re: Brief Discharge Summary We are faxing to you the Brief Discharge Summary on a patient who is being discharged from our 1 North Adult Unit and who is connected to you either through current provision of services or referral for new services. The Discharge Summary includes the following information: • • • • Diagnosis and course of hospitalization Medications prescribed, if any (Discharge Medication Order Sheet) Follow-up appointments & providers (Patient Appointments Sheet) Family contact information (Patient Appointments Sheet) Please contact the Psychiatrist or Social Worker listed on the discharge paperwork if there are any questions concerning the faxed information. They can be reached at 843-792-0100. Thank you for providing ongoing care for this patient. If you have received this communication in error, please notify the MUSC Compliance Office immediately at 843-792-4037 or 1-800-296-0269. Thank you. The documents accompanying this facsimile/electronic transmission contain confidential information intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential, and exempt from disclosure. If the reader of this message is not the intended recipient, or an employee responsible for delivering the message to the intended recipient, you are hereby notified that any disclosure, dissemination, distribution, or copying of this communication is strictly prohibited. n:\psywp\iop\iop_discharge_fax-cover-sheet_1N.docx\1 Rev. 5/2/14