1. Against Medical Advice Declaration: Additional declarations and warnings required when patient is leaving against medical advice

2. Mental Capacity Assessment: Required when there are concerns about the patient's capacity to make informed decisions

3. Guardian/Power of Attorney Details: Required when someone other than the patient has legal authority to sign

4. Interpreter Declaration: Required when an interpreter has been used to explain the release form

5. Medicare/Insurance Details: Required for billing and insurance purposes when applicable

6. Transportation Arrangements: Required when specific transport arrangements need to be documented

7. Special Care Instructions: Required for patients with complex care needs or specific medical conditions

1. Schedule A - Medication List: Detailed list of prescribed medications, dosages, and administration instructions

2. Schedule B - Follow-up Appointments: Schedule of follow-up appointments and contact information for relevant healthcare providers

3. Schedule C - Home Care Instructions: Detailed instructions for wound care, exercise, diet, or other specific care requirements

4. Appendix 1 - Patient Rights and Responsibilities: Standard information about patient rights and responsibilities post-discharge

5. Appendix 2 - Emergency Services Contacts: List of relevant emergency contacts and services