DISCHARGE SUMMARY
Discharge Summary Generator
The discharge summary is the last note in the file and the one most likely to be read months later. It states what changed, why services stopped, and what happens next.
No recording. No account needed to try. Nothing you type leaves your browser.
Works with OT · PT · SLP · BCBA credentials · Insurance, Medicare, Medicaid and school settings · 50-state formats
How compliance works
1Who you are
2This session
3Your note
Fill the form above and press Generate note to see your record here.
How this works
Document outcomes, not activity
The summary should state the level of function at discharge compared with the initial evaluation. If your initial note recorded a baseline, restate it beside the discharge level. "Completed 12 visits" is activity. "Improved from partial assistance to independent with sit-to-stand" is an outcome.
Name the reason services are ending
Goals met, plateau reached, client declined further services, moved, or transitioned to a different level of care. Ambiguity here is what generates a follow-up inquiry three months later. The discharge selector produces a clear closing statement with the criteria language your setting expects.
The home program is what protects the outcome
A discharge with no carryover plan invites re-referral. The generated summary includes the home program line and caregiver instruction statement when you select those interventions, which also documents that you provided them.
Questions
Common questions
Do I need a discharge summary if the client just stopped coming?
Yes — an administrative discharge note is far better than a file with no closure. Select discharge, note that the client did not return, and state the outcome at the last attended visit.
Should I include standardized test scores?
If you re-administered a standardized measure at discharge, enter the score in the observation field. A pre-post comparison is the strongest single piece of outcome evidence you can put in a record.