A transfer note, or transfer summary, goes with a patient who moves to another level of care or another facility: why they are moving, where each problem stands, and what the receiving team must do next. Copy the free template, see an ICU to ward step-down after septic shock and a hospital to hospital STEMI transfer, and check what goes in each part.
Blank transfer note template
FreeTRANSFER NOTE Patient: [Name] Date of birth or ID: [Identifier] Date and time of transfer: [Date, time] From: [Unit or hospital, service, and attending] To: [Unit or hospital, service, and accepting physician] Type of transfer: [ICU to ward, ward to ICU, change of service, hospital to hospital, or hospital to rehabilitation or long-term care] Transport and escort: [Bed move with a nurse, ground ambulance, critical care transport, or air] Author: [Name, credentials] REASON FOR TRANSFER Reason: [Why the patient is moving now, in one or two sentences] Readiness or need: [For a step-down, the criteria met; for a step-up or a transfer out, the care this unit or hospital can't give] Accepted by: [Accepting physician, how they were reached, and the time] SUMMARY OF STAY Admission: [Date, presenting problem, and admitting diagnosis] Course: [Key events, procedures, and treatments in date order, in a few lines] Condition now: [Latest vital signs with oxygen, mental status, and the trend over 24 hours] ACTIVE PROBLEMS Problem 1: [Problem, status today, and the plan the receiving team should carry on] Problem 2: [Problem, status today, and plan] Resolved problems: [Problems settled during the stay, so they aren't worked up again] Chronic conditions: [Home medications continued, held, or changed, and when to restart] MEDICATIONS AND ALLERGIES Current medications: [Drug, dose, route, frequency, and the time of the last dose] Recent changes: [Started, stopped, or changed in the last 48 hours, and why] Antimicrobials: [Drug, day number, and planned stop date] Infusions: [Insulin, heparin, or other drips, with the rate and protocol, or stopped and what replaced them] Allergies: [Drug, food, latex, and contrast allergies, with the reaction] LINES, DRAINS, AND DEVICES Access: [Each line, its site, the date placed, and whether it is still needed] Drains and tubes: [Urinary catheter, chest tube, feeding tube, or surgical drain, with output and plan] Breathing support: [Oxygen device and flow, high-flow or noninvasive settings, or tracheostomy] Other devices: [Telemetry, pacing wires, pumps, defibrillator pads, or wound vacuum] SAFETY Code status and goals of care: [Decision, who took part, when last confirmed, and the named decision-maker] Isolation: [Precautions and the organism, or none] Risks: [Falls, delirium, aspiration, pressure injury, restraints, or one-to-one observation] VTE prophylaxis: [Agent and dose, mechanical, or why not] Diet: [Diet ordered, swallow screen result, or NPO and why] PENDING AND FOLLOW-UP Pending results: [Each test, the date sent, and who will follow it up] Consultants: [Each service involved, its latest advice, and whether it keeps following] Tasks for the receiving team: [What needs doing, and by when] Escalation: [What should prompt a call or a move back, and who to call] COMMUNICATION Family: [Name, relationship, and what they were told about the transfer] Patient: [What the patient understands, and agreement to the transfer] Verbal handover: [Given to name and role, at what time, with I-PASS, SBAR, or your unit's tool; questions answered] Records sent: [Notes, imaging, medication record, and results sent with the patient or shared electronically] Signed: [Clinician name, credentials, date and time]
Use it for
Each one follows the template. Use them to judge how much detail every part needs.
Medical ICU to the general medicine ward, ICU day 5
Step-down from the medical ICU to the general medicine ward on November 9, 2026, at 10:00, by bed with an ICU nurse. Septic shock resolved: off norepinephrine for 36 hours, lactate 1.1 mmol/L, on 2 L/min nasal cannula, and no longer needs ICU monitoring or nursing. Accepted by the ward attending at 08:40, through the bed manager.
64-year-old man with type 2 diabetes and hypertension, a former smoker of 30 pack-years. Admitted November 5 with 3 days of cough, fever, and rigors: T 39.2 °C (102.6 °F), HR 124, BP 78/44, RR 30, SpO2 86% on room air, lactate 5.1 mmol/L, left lower lobe consolidation on chest X-ray. Lactated Ringer’s 2.5 L (30 mL/kg), then norepinephrine through a right internal jugular line, peak 0.15 mcg/kg/min, stopped November 7 at 22:00. High-flow nasal oxygen 50 L/min at FiO2 0.6 on day 1, weaned to nasal cannula on November 7; never intubated. Now: T max 37.4 °C (99.3 °F), HR 84 to 96, BP 118 to 136/68 to 78, RR 18 to 22, SpO2 93 to 96% on 2 L/min. Alert and oriented; his wife says he is back to himself.
1. Pneumococcal pneumonia, improving. Sputum grew Streptococcus pneumoniae, penicillin-susceptible; urine pneumococcal antigen positive. Ceftriaxone day 5. Switch to amoxicillin 1 g by mouth three times daily tomorrow morning if afebrile and eating, for 7 days of antibiotics in total, last dose November 11. Wean oxygen to keep SpO2 92 to 96%. 2. Acute kidney injury, recovering: creatinine 2.3 mg/dL (203 µmol/L) on admission, 1.3 mg/dL (115 µmol/L) today; baseline 0.9 mg/dL (80 µmol/L). Urine output good. Net 4.6 L positive since admission, weight 86 kg from 82 kg, mild ankle swelling; no diuretic yet, reassess with tomorrow’s creatinine. 3. Type 2 diabetes, A1c 8.4%: insulin infusion stopped November 8 at 23:00, 2 hours after a first dose of glargine 16 units. Glucose 7.2 to 11.0 mmol/L (130 to 198 mg/dL) since. Titrate glargine daily. Resolved: shock; ICU delirium, CAM-ICU positive November 6 and 7, negative since the morning of November 8. Held: lisinopril 20 mg and metformin 1,000 mg twice daily, to restart when creatinine is near baseline.
Ceftriaxone 2 g IV daily, last 06:00 today, day 5. Glargine 16 units at 21:00, last given last night. Lispro correction scale with meals. Enoxaparin 40 mg subcutaneously daily, last 08:00 today. Atorvastatin 40 mg at night, his home dose. Acetaminophen 1 g every 6 hours as needed, no more than 3 g a day. Stopped today: pantoprazole 40 mg IV, stress ulcer prophylaxis, no longer needed now that he is off vasopressors and eating. Stopped November 8: quetiapine 25 mg at night, given 2 nights for ICU delirium; not to continue on the ward. Vancomycin given November 5 and 6, stopped when the MRSA nasal swab came back negative. Azithromycin 3 days, completed November 7. Allergies: none known.
Right internal jugular central line, placed November 5, removed today at 08:15; site dry. Left radial arterial line removed November 7. Two 20-gauge peripheral IVs, left forearm and right hand, placed November 8. Urinary catheter removed November 8 at 06:00; voiding, post-void bladder scan 80 mL. Nasal cannula at 2 L/min. No drains.
Code status: full code, confirmed with him on November 8 once his delirium cleared; his wife is his named decision-maker. Isolation: none; influenza, COVID-19, and RSV tests negative on November 5. Risks: falls, as he walks 20 m with a walker and one person to help; delirium could return, so glasses on, sleep at night, and no sedatives. Swallow screen passed November 7. VTE prophylaxis: enoxaparin as above. Diet: consistent carbohydrate.
Pending: blood cultures from November 5, no growth at 4 days, final report due November 10; the ward team will check it. Chest imaging at 6 to 8 weeks to confirm the consolidation has cleared, as he is a former smoker over 50; the ward team will put it in the discharge letter for his family doctor. Consultants: none. Physical therapy daily. The ICU outreach team will review him on the ward tomorrow morning. Tasks today: creatinine, potassium, and glucose before meals and at bedtime; daily weight. Escalation: call the rapid response team for systolic BP below 90, SpO2 below 92% on 4 L/min, RR above 25, new confusion, or a temperature above 38.5 °C (101.3 °F) with rigors. The ICU attending decides on any readmission.
His wife was at the bedside for the move; told why he is ready for the ward, the room number, and the visiting hours. He agrees with the move. Verbal handover: I-PASS from the ICU resident to the ward resident, Dr. Lindqvist, by phone at 09:30; illness severity “watcher”; she read back the action list and asked about the antibiotic switch. ICU nurse to ward nurse at 09:50. Records: all notes, results, and the medication record are in the shared electronic record.
Community hospital emergency department to a PCI center, critical care ground ambulance
Inferior STEMI needing primary PCI, which this hospital can’t provide: no cardiac catheterization lab. PCI center 70 km away, about 45 minutes by ground, so the expected time from first contact to the balloon is under 120 minutes and primary PCI is preferred to fibrinolysis. ECG sent to the regional STEMI line at 07:31; accepted by the on-call interventional cardiologist, Dr. Huang, at 07:36; cath lab activated, and he goes straight to the lab, bypassing their emergency department. Critical care paramedic crew, defibrillator pads on.
61-year-old man with hypertension and type 2 diabetes who smokes 15 cigarettes a day. Central chest pressure with sweating and nausea since 06:40. Arrived by car at 07:25. ECG at 07:29: sinus bradycardia 54, ST elevation of 3 mm in II, III, and aVF, ST depression in I and aVL. Right-sided leads: 1 mm ST elevation in V4R, so right ventricular involvement. BP 96/58 on arrival, 108/66 after 250 mL of normal saline. SpO2 97% on room air, so no oxygen. Clammy, JVP raised, lungs clear, no new murmur. Killip class I. Left at 07:53: 28 minutes from arrival to departure.
1. Inferior STEMI with right ventricular involvement: for primary PCI. Pain 6 out of 10 at departure, from 8. 2. Low blood pressure, fluid-responsive: he depends on preload, so no nitroglycerin. 3. Sinus bradycardia 50 to 56, no block, with a stable blood pressure: watch. 4. Type 2 diabetes: glucose 9.4 mmol/L (169 mg/dL); no insulin given. 5. Hypertension: ramipril held while BP is low.
Given here: aspirin 325 mg chewed at 07:31. Ticagrelor 180 mg at 07:40, as asked by Dr. Huang. Unfractionated heparin 4,000 units IV bolus at 07:42, by the regional transfer protocol; no infusion. Ondansetron 4 mg IV at 07:35. No nitroglycerin and no morphine. Home medications: metformin 1,000 mg twice daily, last dose 19:00 yesterday; ramipril 10 mg daily, last dose yesterday morning; atorvastatin 20 mg at night. The receiving team will decide when to restart metformin after contrast. Allergies: iodinated contrast, hives after a CT in 2021, with no breathing trouble or swelling. Told to Dr. Huang at acceptance; he will manage it in the lab, and no premedication was given here.
Two peripheral IVs, 18-gauge in the left antecubital fossa and 20-gauge in the left hand, both in the left arm to keep the right wrist free for radial access. Defibrillator pads on and connected to the transport monitor. No urinary catheter.
Code status: full code, discussed with him; he has capacity and wants all treatment. Isolation: none. Risks in transport: ventricular arrhythmia, so pads on and the crew ready to defibrillate. Low blood pressure: normal saline 250 mL boluses for systolic below 90, up to 1 L, and no nitrates. Bradycardia with low blood pressure: atropine 1 mg IV, repeated every 3 to 5 minutes up to 3 mg, then pacing through the pads. Bleeding risk on heparin and two antiplatelet drugs. Diet: NPO.
Pending: lipid panel and A1c drawn at 07:35. Our emergency department will fax both results to the receiving cardiac unit by noon. High-sensitivity troponin I was 64 ng/L at 07:35; no repeat drawn before he left. Consultants: interventional cardiology at the PCI center, now responsible. Escalation in transport: the crew calls Dr. Huang on the STEMI line for a systolic below 80 despite fluid or a new heart block, and follows its cardiac arrest protocol, diverting to the nearest emergency department, if he arrests.
His wife was reached by phone at 07:45. Told he is going straight to the cath lab, to drive there herself rather than follow the ambulance, and to wait at the cardiac unit desk. He agreed to the transfer after the risks of transport and the benefit of PCI were explained, and signed the transfer consent. Verbal handover: SBAR to Dr. Huang on the recorded STEMI line at 07:33. ED nurse to the transport paramedic at the bedside at 07:50, with read-back of the drug times. Records sent with the crew: both ECGs, this note, the medication record with times, and the lab results; also faxed ahead.
Why the patient is moving now, and who agreed to take them. The receiving team reads this first and plans the bed, the staff, and the first hour from it.
Avoid: “Transferred for a higher level of care” on its own. Name what the patient needs, such as PCI, neurosurgery, or dialysis, and why it can’t be done where they are.
The stay in a few lines, so the receiving team understands the patient without reading the whole chart.
Avoid: Pasting the admission H&P or every daily note. The receiving team needs the course, not the record.
Each problem with its status today and the plan the receiving team should carry on, with end points.
Avoid: A problem list with no plan. The receiving team then rebuilds it from scratch, or stops something that was meant to continue.
What the patient takes now and what changed in the last 48 hours, with last dose times, so nothing is doubled or missed in the move.
Avoid: ICU orders that ride along to the ward. Stop or convert sedatives, stress ulcer prophylaxis, and insulin or heparin drips before the move, and say so.
Every device the patient arrives with, its day, and whether it still needs to be there.
Avoid: A central line that leaves the ICU with no plan. Take it out before the move, or write why it stays and who will remove it.
The decisions and risks that must arrive with the patient, not a day later.
Avoid: A code status decision that stays behind. A choice made at an ICU family meeting must be in the note and in the receiving unit’s orders.
What is still outstanding, who owns each item, and when to call for help.
Avoid: Results that come back to the sending team after the patient has gone. Name who follows each one.
Who was told what, and the verbal handover that goes with the note, recorded by name and time.
Avoid: A note with no verbal handover, or a handover with no note. Each catches what the other misses.
Sedatives, antipsychotics started for delirium, stress ulcer prophylaxis, and insulin drips often outlast the reason for them. Stop or convert each one before the move, and write what replaced it.
The receiving team triages on the reason. Name the service the patient needs, such as PCI, neurosurgery, or dialysis, and why it isn’t available where they are.
A central line or urinary catheter that moves to the ward with no plan stays in for days. Remove it before transfer, or write its day number, why it stays, and who will take it out.
Tests sent before the move come back to the team that ordered them. Write who follows each pending result, and send copies ahead for a transfer to another hospital.
“Handover given” can’t be checked later. Record who received it, when, and which tool you used, and note the questions they asked.
Vero Scribe drafts the transfer note in your template from your dictation, or from your conversation with the patient and family, with their consent. You review and edit every section, then copy it into your record or export it to Word or PDF. Vero works in 60+ languages.
Whenever a patient moves to a different level of care or a different place: ICU to ward, ward to ICU or step-down, one service to another, one hospital to another, or hospital to a rehabilitation unit or long-term care home. A shift change on the same unit uses a handover instead.
Start with why the patient is moving and who accepted them. Summarize the stay in a few lines, then give each active problem its status and plan. List current medications with last dose times and recent changes, every line and device, code status, isolation, and allergies. Finish with pending results and who follows each one, the consultants involved, family contact, and the name and time of the verbal handover.
A discharge summary closes a hospital stay. A transfer summary goes with a patient whose care continues somewhere else in hospital. When a patient moves to another hospital, the stay at yours ends, so many organizations ask for both: the transfer note travels with the patient, and the discharge summary stays in your record.
The sending team writes the transfer note. The receiving team then writes an accept note, or transfer-in note: they confirm the history, examine the patient, reconcile the medications and orders, and record their own plan. The transfer note is where they start.
No. Give a structured verbal handover as well, with I-PASS, SBAR, or the tool your unit uses, so the receiving clinician can ask questions. I-PASS covers illness severity, a patient summary, an action list, situation awareness and contingency plans, and a synthesis by the receiver. Record who received the handover and when.
Yes. Copy it, or download it as a Word or text file. No account needed.
The daily inpatient note: overnight events, trends, a plan by problem, and the daily checklist.
The full adult admission workup, with medication reconciliation, goals of care, and level of care.
Answer another team’s question: a focused history, a direct answer, and numbered recommendations.
The record of a hospital stay: diagnoses, course by problem, procedures, medicine changes, pending results, follow-up, and code status.
The one-page letter to the family doctor at discharge: requests with dates, medicine changes, and pending results.
Inpatient notes and letters, drafted for your review.
ICU notes and handoff documents, drafted for your review.
Handoff and escalation examples, with how SBAR and I-PASS differ.
Check the medicine list at each transfer of care.
Vero writes your notes and letters in the templates you choose, so you review instead of type.
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