Urology Discharge Instructions Generator

Practice Preset

Quick-fill from saved practice

✓ Practice info filled in below

Patient Information

Patient Name

Date of Birth

Procedure Date

MRN

Provider Information

Surgeon Name

Practice / Clinic

Practice Address

Office Phone *

Office phone is required.

After-Hours Phone

Procedure

Procedure Type *

Please select a procedure.

Robotic Platform

Side

Catheter Placed?

Catheter Type

Expected Removal (days)

– days

Patient removes catheter at home?

Ureteral Stent Placed?

Stent String Visible?

Expected Removal (weeks)

– weeks

Nephrostomy Tube Left?

Planned Removal (days)

– days

Surgical Drain Placed?

Nerve Sparing

Prescribed Medications (all optional)

Antibiotic(s)

Pain Medication

Other Medications

Follow-Up Appointment (all optional)

Date

Time

Follow-up With

Location

Purpose of Visit

Additional Notes (optional)

No instructions generated yet

Fill in the form and click Generate Discharge Instructions.

ASN

Notes by Akhil Saji