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Table of Contents

  1. Agreement Template Bundle
  2. 5 Steps to Make Patient Transfer Agreement
  3. 6+ Patient Transfer Agreement Templates
  4. 1. Sample Patient Transfer Agreement Template
  5. 2. Patient Transfer Agreement Example
  6. 3. Generic Patient Transfer Agreement Format
  7. 4. Patient Transfer Agreement Template
  8. 5. Standard Patient Transfer Agreement Example
  9. 6. Patient Transfer Agreement in PDF
  10. 7. Simple Patient Transfer Agreement Format

6+ Patient Transfer Agreement Templates

Patient transfer agreements are prepared and signed between the two parties to shift the patient immediately to the best care center. This agreement is done when a medical institution witnesses that they are not being able to make any improvement in the patient’s condition. We have designed several Patient transfer agreement template that you can choose from to frame your agreement. Have a look at them!

Agreement Template Bundle

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  • MS Word
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5 Steps to Make Patient Transfer Agreement

Step 1: Hospital Details

The patient transfer agreement should begin by specifying the details of the hospitals. It means the hospital the patient was admitted in and the one in which he or she is being transferred to.

Step 2: Matter Description

The reason to make such a transfer needs to be specified in the description. The facility the current hospital is lacking in to provide the patient and what the next one can provide should be added.

Step 3: Medical Records

The agreement should carry all the details on all the important, major or minor information of the patient’s health. It is better if you attach a health history report in the agreement file. Because the details can help the next hospital to act quickly.

Step 4: Transferring Facility

The patients who get transferred to other hospitals immediately suffer from critical conditions that is why you should provide an immediate transfer facility available. You should also ask the other hospital party to receive the patients.

Step 5: Signatures

The agreement file, at last, should be having some space where both the parties would sign. The signatures should be given after studying the agreement properly from both the ends.

6+ Patient Transfer Agreement Templates

1. Sample Patient Transfer Agreement Template

sample patient transfer agreement templateeapsa.org
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  • PDF

Size: 101.7 KB

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If you have monitored that your medical facility could not make many improvements, in any case, it is better to prepare a proper agreement. A proper agreement file can help to shift the patient in a proper care unit. You can use this agreement sample to make your work quick as even a second matters in critical situations. So download this template now and keep this agreement ready for different cases that you might face.

2. Patient Transfer Agreement Example

patient transfer agreement examplechoa.org
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  • PDF

Size: 320.9 KB

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If you are observing that the current medication can not cure the patients admitted it is better to consult the family member of the patient. With their consent, you can frame a proper document that can make a proper document on transfer. Or you can choose this agreement sample template to make it a quick process for quick shifting of the patient.

3. Generic Patient Transfer Agreement Format

generic patient transfer agreement formatkdheks.gov
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  • PDF

Size: 156.0 KB

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If your hospital seems failing at serving the critical conditions of the patient admitted, you can make an agreement with the other well-equipped hospital. This agreement should add all the specifications of the condition of the patient. You can choose this agreement example template that has already created the structure that you may use to shape your agreement. So have a look at this template today!

4. Patient Transfer Agreement Template

patient transfer agreement templatemichigan.gov
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  • PDF

Size: 75.6 KB

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If you are dealing with the case of transferring patients to other hospitals you should keep stress about the condition of the patient in the agreement. You can just download this agreement example that has framed the crucial points in it. For example, this agreement apart from the critical condition of the patient also stresses on the transportation facilities and responsibilities.

5. Standard Patient Transfer Agreement Example

standard patient transfer agreement examplehospitalcouncil.org
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  • PDF

Size: 60.8 KB

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There are different formats that a patient transfer agreement follows. It depends on the nature of the condition that needs to be addressed. If you are designing one you can save your time by having a look at this transfer agreement. The template has followed standard structures and following the format defines the medical condition of the patient who is being transferred. Choose this template to shape your agreement.

6. Patient Transfer Agreement in PDF

patient transfer agreement in pdfillinois.gov
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  • PDF

Size: 148.8 KB

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Framing a long agreement for transferring any serious patient might not be easy that is why we suggest you choose this template. Designed addressing the main issue this template can help you to convey quick information to the other party. Have a look at the message and if you find it useful the template is only a click away. Apart from this, you can also refer to our agreement forms in PDF format.

7. Simple Patient Transfer Agreement Format

simple patient transfer agreement formatsrhd.org
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  • DOC

Size: 11.8 KB

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The given sample is one simple frame of transfer agreement for patients who need to be shifted to other hospitals for intensive care. The structure has minutely framed the medical condition of the patient. If you too need to design such an agreement choose this template. We also have some free agreement templates that you may try as they are free of cost.

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