A patient summary is a one-to-two-page picture of a patient’s health that travels with them: who cares for them, what they live with, what they take, what they have decided, and what is still pending. Copy the free template, the readable version of a Continuity of Care Document, see a move to long-term care and a type 1 diabetes handover, and check what goes in each part.
Blank patient summary template
FreePATIENT SUMMARY Patient: [Full name, preferred name, pronouns] Date of birth: [Date] Address and phone: [Current address and phone, and the new address if moving] Language and communication: [Preferred language, whether an interpreter is needed, hearing, vision, or speech needs] Prepared on: [Date] Prepared by: [Name, role, practice, phone] Purpose: [Transfer to another facility, new primary care clinician, referral, travel, or the patient's own copy] Sources: [Clinic record, pharmacy record, specialist letters, hospital summaries, patient or family, with dates] CONTACTS AND CARE TEAM Emergency contact: [Name, relationship, phone] Decision-maker: [Who makes health decisions if the patient can't, and the document that names them, or none named] Primary care clinician: [Name, practice, phone] Specialists: [Name, specialty, what they manage, phone] Other services: [Pharmacy, home care, therapists, community programs, with phone numbers] ACTIVE PROBLEMS [For each: the problem, the year diagnosed, its status such as stable, improving, or worsening, the latest key measure, and who manages it] PAST HISTORY THAT STILL MATTERS Past conditions and surgeries: [Only those that affect care now, with years] Hospital stays in the past year: [Dates and reasons, or none] MEDICATIONS Current: [Each medicine with strength, dose, and when it's taken, and what it's for] Recently stopped or changed: [Medicine, date, and why, or none] Who manages medicines: [Patient, family, pharmacy packs, or nursing staff] Last checked against: [Pharmacy record, the medicines themselves, or both, with the date] ALLERGIES AND INTOLERANCES [Substance, reaction, and year, marked as an allergy or an intolerance, or no known allergies] IMMUNIZATIONS [Vaccine and date of the last dose: influenza, COVID-19, pneumococcal, tetanus, shingles, RSV, hepatitis B, or others] KEY RESULTS [The latest results that matter for the active problems, with dates and the patient's usual values] Vital signs and weight: [Latest readings with the date, and the usual or dry weight] IMPLANTED DEVICES AND AIDS Implanted devices: [Pacemaker, defibrillator, stent, joint replacement, insulin pump, or none, with the year and who follows it] Aids that travel with the patient: [Hearing aids, glasses, dentures, walker, or none] FUNCTIONAL STATUS Mobility and falls: [Walks alone or with an aid, and falls in the past year] Daily activities: [Bathing, dressing, eating, toileting, medicines: independent or the help needed] Cognition: [Usual memory and orientation, with any score and its date] ADVANCE DIRECTIVES AND GOALS OF CARE Resuscitation: [Attempt CPR, do not attempt CPR, or not yet discussed, with the date and who decided] Documents: [Advance directive, power of attorney, or medical orders, with dates and where the originals are] Goals of care: [What matters most to the patient, in their words] Treatment limits: [Hospital transfer, intensive care, ventilation, dialysis, or no limits set] SOCIAL CONTEXT Living situation: [Home, alone or with others, stairs, or a care facility] Supports: [Family, caregivers, and services, and how often] Work and daily life: [Work, school, driving, activities that matter to the patient] Substance use: [Tobacco, alcohol, cannabis, or other, with amounts] PENDING ITEMS Results awaited: [Test, date done, and who will follow up] Referrals and appointments: [Service and date, or still waiting] For the next clinician: [What to check first, and when] Shared with: [Patient, family, receiving clinician or facility, pharmacy, with the date]
Use it for
Each one follows the template. Use them to judge how much detail every part needs.
Family physician, summary sent ahead of a move from home to a long-term care home
Arthur Pell, born March 3, 1948, age 78. English; wears hearing aids in both ears, so speak slowly and face him. Purpose: his move from his own home to Maplewood Care Home on Monday, November 16, 2026, for the home’s physician, nurses, and pharmacy. Sources: my clinic record, the cardiology letter of August 20, 2026, the pharmacy dispensing record, and his daughter, who has managed his medicines since 2025. Prepared November 9, 2026, by Dr. Hannah Osei, family physician.
Daughter, emergency contact, and his power of attorney for health decisions: Linda Moreno, 555-0162; document signed in 2023, copy attached. Son: David Pell, lives abroad, calls weekly. Family physician: Dr. Hannah Osei, Northgate Family Practice, 555-0110, until the home’s physician takes over. Cardiologist: Dr. Victor Lam, 555-0175, for heart failure and atrial fibrillation. Pharmacy: Northgate Pharmacy, 555-0131, which packs his weekly blister packs until the home’s pharmacy takes over.
1. Heart failure with preserved ejection fraction, since 2021: stable since a hospital stay in May 2026; dry weight 70 kg. Dr. Lam. 2. Atrial fibrillation, permanent, since 2019: resting heart rate in the 60s and 70s; on apixaban to prevent stroke. Dr. Lam. 3. Alzheimer’s dementia, mild, diagnosed June 2025: slowly worsening, and the reason for the move, as he can no longer manage alone. Dr. Osei. 4. Chronic kidney disease, stage 3b: eGFR in the 40s for 2 years. 5. Osteoarthritis of both knees. Past history that still matters: right total hip replacement, 2015. Hospital stay in May 2026, 5 days, for heart failure after a chest infection. Delirium with a urinary tract infection in 2025.
Apixaban 5 mg twice a day. Metoprolol succinate 50 mg each morning. Furosemide 40 mg each morning, reduced from 40 mg twice a day on October 28 for lightheadedness on standing; weight steady since. Empagliflozin 10 mg each morning. Donepezil 10 mg at bedtime. Acetaminophen 1,000 mg up to 3 times a day if needed for knee pain. Stopped: lorazepam 0.5 mg at bedtime, tapered off by August 2026 after a fall in March; please don’t restart it. Checked against the pharmacy record and his blister pack on November 9. Codeine: vomiting and confusion in 2019, an intolerance, not an allergy. No known drug allergies. Immunizations: influenza and COVID-19, October 6, 2026; RSV, 2024; pneumococcal conjugate, 2023; shingles, 2 doses, 2022; tetanus and diphtheria, 2018.
October 28, 2026: creatinine 1.4 mg/dL, or 124 µmol/L; eGFR 44, his usual; potassium 4.3 mmol/L; sodium 137 mmol/L; hemoglobin 12.4 g/dL. NT-proBNP 1,280 pg/mL, down from 3,900 in May. Echocardiogram, August 2026: ejection fraction 55%, enlarged left atrium. Today: weight 70.4 kg, blood pressure 124/70, pulse 66 and irregular, oxygen saturation 95% on room air. Implanted: right hip prosthesis, 2015; no pacemaker. Hearing aids, reading glasses, a partial upper denture, and his four-wheeled walker go with him.
Walks indoors with the walker; wheelchair for longer distances. One fall in the past year, at night on the way to the bathroom in March 2026, without injury. Needs help to shower and prompting to dress; eats on his own, normal diet and thin fluids. Continent by day, with some urgency at night. MoCA 19 of 30 in September 2026, from 22 in June 2025. Knows his family and where he is; often unsure of the date. More confused in the evenings. Sudden new confusion has been the first sign of infection for him.
Resuscitation: do not attempt CPR. Decided by Mr. Pell on September 22, 2026, with me and his daughter; he had capacity for this decision and gave his reasons in his own words. The signed do-not-resuscitate order goes with him. His goals: “Keep me comfortable, keep my routines, and don’t send me to hospital for things you can fix here.” Hospital transfer: yes for a broken bone or a problem the home can’t treat; no intensive care, breathing machine, or dialysis. His daughter decides for him under the power of attorney if he no longer can.
Widowed in 2024; lived alone in a 2-story house, with his daughter visiting daily. Retired bus mechanic. Likes baseball on the radio and a beer with Sunday lunch, which his family hopes he can keep. Would welcome visits from the home’s chaplain. Quit smoking in 1990; stopped driving in 2025. Pending: creatinine, potassium, and weight by November 25, 4 weeks after the furosemide change; the home’s physician to follow up. Cardiology review with Dr. Lam on January 14, 2027. Check first: weigh him 3 mornings a week, and call if he gains more than 2 kg in 3 days or is more short of breath. A pulse below 50, dizziness, or fainting needs review, as donepezil and metoprolol both slow the heart. Apixaban 5 mg twice a day is the right dose now; review it when he turns 80 in March 2028, or if his weight falls to 60 kg or below or his creatinine reaches 1.5 mg/dL, as any 2 of those 3 call for 2.5 mg twice a day.
Family physician, summary for a patient moving for work; one copy for her, one for her new primary care clinician
Maya Lindgren, born April 18, 1994, age 32, she and her. English. Purpose: handover to her new primary care clinician after her move on November 28, 2026, for a new job; first visit booked with Dr. Sofia Mendes, Lakeside Health, on December 10. A copy for her to keep with her pump supplies. Sources: my record, her endocrinology letters to October 2026, her pump and glucose monitor reports, and the pharmacy record. Prepared November 6, 2026, by Dr. Paul Adeyemi, family physician.
Partner and emergency contact: Jonah Reyes, 555-0188, who knows how to give her nasal glucagon. Family physician until the move: Dr. Paul Adeyemi, Riverbend Medical, 555-0120. Endocrinologist: Dr. Ines Carvalho, Riverbend Diabetes Clinic, 555-0144, for her pump settings and diabetes care. Referral to a diabetes clinic in her new city sent November 2. Pharmacy: Riverbend Pharmacy, 555-0139.
1. Type 1 diabetes since 2005, age 11: on a tubed insulin pump with automated insulin delivery, linked to a continuous glucose monitor, since 2021. A1c 7.1% in October 2026, from 7.6% in 2024. Feels her lows coming on. No complications found. Dr. Carvalho. 2. Autoimmune hypothyroidism, since 2018: stable on levothyroxine. Dr. Adeyemi. 3. Pregnancy planning: levonorgestrel IUD placed 2023; hopes to conceive in the next 1 to 2 years. Past history that still matters: diabetic ketoacidosis once, at diagnosis. One severe low in 2019 after a long hike, treated with glucagon by her partner; none since. Celiac screen negative, 2024.
Insulin aspart in the pump, about 40 units a day, roughly half as basal. Settings at handover: 1 unit per 10 g of carbohydrate; 1 unit lowers her glucose about 2.5 mmol/L, or 45 mg/dL; target 6.1 mmol/L, or 110 mg/dL. Full settings printout attached. Backup if the pump fails: insulin glargine 20 units once a day, about her daily pump basal, with aspart by pen for meals and corrections; Dr. Carvalho’s written plan for going back on the pump is attached. Levothyroxine 88 mcg each morning. Nasal glucagon 3 mg for a severe low: 1 at home, 1 in her bag. Ketone strips and glucose tablets. No known drug allergies. Skin reaction to the adhesive on an earlier glucose sensor; a barrier film under each sensor prevents it. Immunizations: influenza, October 2026; COVID-19, 2025; pneumococcal conjugate, 2024; tetanus, diphtheria, and pertussis, 2022; hepatitis B and HPV series complete.
A1c 7.1%, October 12, 2026. Glucose monitor, last 14 days: 68% of time in range, 3.9 to 10.0 mmol/L or 70 to 180 mg/dL; 3% below 3.9 mmol/L; under 1% below 3.0 mmol/L, or 54 mg/dL; worn 96% of the time. October 2026: TSH 2.1 mIU/L; urine albumin-to-creatinine ratio normal; eGFR above 90; LDL cholesterol 2.4 mmol/L, or 93 mg/dL. Retinal screening, February 2026: no retinopathy. Foot exam, October 2026: normal sensation and pulses. Blood pressure 116/72; BMI 23. Devices: insulin pump since 2021, warranty ends August 2027, infusion set changed every 3 days; glucose sensor changed every 10 days. Both come off before an MRI or CT scan, as the makers advise.
Fully independent. Runs 3 times a week, using the pump’s exercise setting and carrying glucose tablets. Some site days in her new job start at 6 a.m. outdoors. No memory or mood concerns; PHQ-2 0 and low diabetes distress at her October visit.
Full resuscitation. No advance directive; she would want her partner to decide for her, and plans to put that in writing after the move. Her goals: keep her A1c near 7% without more lows, and be ready for a healthy pregnancy.
Moving with her partner for a job as a civil engineer, starting December 1. About 4 drinks a week; never smoked; no cannabis. Drives; checks her glucose before driving and keeps fast sugar in the car. Pending: prescriptions for pump supplies and glucose sensors run out at the end of January 2027; please renew them at the December 10 visit. A 90-day supply of insulin, glucagon, and levothyroxine was given on November 6. First diabetes clinic visit in her new city expected in February 2027. Retinal screening due February 2027. Before she has the IUD removed: a preconception visit to aim for an A1c below 6.5% if she can reach it without lows, start folic acid, and recheck her thyroid dose. A statin was discussed and deferred while she plans pregnancy; revisit after.
Who the summary is about, why it was written, and how current it is. The reader decides how far to trust it from this block.
Avoid: A summary with no date. A reader can’t tell whether it was checked last week or printed from a chart 2 years ago.
Who to call, and who decides if the patient can’t.
Avoid: A name with no role. “Dr. Lam, cardiology, for heart failure” tells the reader who to call about what; “Dr. Lam” alone doesn’t.
What the patient lives with now, how each problem is doing, and only the history that still changes care.
Avoid: Copying the whole problem list. Resolved problems from decades ago bury the 4 that matter today.
What the patient takes now, what changed recently, and what they react to, checked against a second source.
Avoid: “Codeine allergy” for a patient who vomited on it. Say what happened, and mark it as an intolerance when it is one.
The latest numbers behind the active problems, and anything implanted or worn that the next team must know.
Avoid: A result with no date or baseline. An eGFR of 44 means one thing if it was 45 last year, and another if it was 70.
How the patient usually moves, manages daily life, and thinks. The next team needs this baseline to notice a change.
Avoid: “Confused” with no baseline. Say how the patient is on a good day.
What the patient has decided, in their words, and where the signed documents are.
Avoid: Leaving this blank because it is in another document. The summary is often the first thing the receiving team reads.
The life around the patient, and every loose end, each with an owner.
Avoid: A pending test with no owner. Results ordered before a move are the ones most often lost.
A list of 30 diagnoses, half of them resolved, hides the few that matter. Give each active problem its status and who manages it, and keep only the past history that still changes care.
A summary built from the chart repeats whatever the chart got wrong. Check the medicines against the pharmacy record or the bottles, and say when you did.
If the resuscitation decision and goals of care aren’t on the summary, the receiving team may not find them until an emergency. Give the decision, the date, who made it, and where the signed document is.
The next team can only spot a change if they know the starting point. Write how the patient walks, manages, and thinks on a usual day, with a score where you have one.
Tests ordered before a move or transfer often have no one to follow them afterward. Name each one, when it’s due, and who will act on it.
Vero Scribe drafts the patient summary in your template from the visit, with the patient’s consent, or from your dictation. You review and edit every section, then copy it into your record or export it to Word or PDF for the next clinician and the patient. Vero works in 60+ languages.
A short record of a patient’s health that another clinician can read in a few minutes: active problems, medicines, allergies, key results, devices, function, goals of care, and what is pending. It goes with the patient at a referral, a transfer, or a change of clinician, and patients can keep a copy.
Identification and contacts, the care team, active problems with their status, past history that still matters, current medicines with doses, allergies and reactions, immunizations, recent key results, implanted devices, functional status, advance directives and goals of care, social context, and pending items. Date it and list your sources.
The Continuity of Care Document, or CCD, is an electronic summary that many health record systems create and exchange when a patient is referred, transferred, or discharged. It is one of the document types in HL7’s Consolidated Clinical Document Architecture, C-CDA, with sections for problems, medications, allergies, results, immunizations, procedures, functional status, social history, advance directives, and the plan of care. This template has the same sections, written for a person to read.
The International Patient Summary, or IPS, is a minimal summary designed to be read in any country, including unplanned care when a patient is away from home. HL7 publishes it as a FHIR standard. Three sections are required: problems, allergies and intolerances, and medicines. Immunizations, results, procedures, and medical devices are recommended, and advance directives, functional status, and social history are optional.
A discharge summary covers one hospital stay: why the patient came in, what was done, and the plan after. A referral letter asks another clinician a question. A patient summary covers the whole patient, asks nothing, and is updated as things change. It often goes with either one.
No. A continuity of care letter is a US letter to a health plan, asking it to keep covering the patient’s current clinician for a transition period, such as during pregnancy or chemotherapy. A patient summary is clinical: it tells the next clinician about the patient. The names are close, but the readers and purposes differ.
One to two pages. Leave out resolved problems unless they still change care, list current medicines rather than every past one, and give the latest results with dates. Attach full reports instead of copying them out.
Yes. A copy helps when they see a new clinician, go to an emergency department, or travel. Write it in plain words where you can, date it, and ask them to bring it to visits and to ask for an update when something changes.
Yes. Copy it, or download it as a Word or text file. No account needed.
The four-part note for most visits, with acute, musculoskeletal, and telehealth examples.
Situation, Background, Assessment, Recommendation: for calls, handoffs, and transfers.
To a specialist or service, with a clear question, the urgency, and the history.
Transitions, handoffs, and patient recaps, drafted for your review.
Visits, handovers, and follow-up, drafted from the conversation.
Admissions, daily rounds, and discharge documents in one workspace.
Vero writes your notes and letters in the templates you choose, so you review instead of type.
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