The Michigan Receipt of Ward and Discharge is a form used by the Michigan Department of Health and Human Services (MD HHS) to document the transfer of a patient from one medical facility to another. This form is also used to document the discharge of a patient from a medical facility. There are two types of Michigan Receipt of Ward and Discharge forms: one for the transfer of a patient from one facility to another and one for discharge of a patient from a medical facility. The form requires the patient’s name, date and time of admission to the receiving facility, date and time of discharge from the sending facility, as well as the name, address, and telephone number of the patient’s guardian. The form also requires the signature of the patient and the guardian. The form must be completed in full and signed by both parties before the transfer or discharge can take place.
Michigan Receipt of Ward and Discharge
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