{% csrf_token %}

Patient: {{ transfer.admission.patient.get_full_name }}

MRN: {{ transfer.admission.patient.mrn }}

Transfer Type: {{ transfer.get_transfer_type_display }}

Priority: {{ transfer.get_priority_display }}

From: {{ transfer.source_ward.name }}, Room {{ transfer.source_bed.room_number }}, Bed {{ transfer.source_bed.bed_number }}

To: {{ transfer.target_ward.name }}, Room {{ transfer.target_bed.room_number }}, Bed {{ transfer.target_bed.bed_number }}

Requested By: {{ transfer.requested_by.get_full_name }}

Requested Time: {{ transfer.requested_datetime|date:"M d, Y H:i" }}

Reason: {{ transfer.get_transfer_reason_display }}

{% if transfer.notes %}

Notes: {{ transfer.notes }}

{% endif %}

Schedule Transfer For *

When should this transfer take place?

Approval Notes

Please provide any additional instructions or notes for this transfer.

I verify that the target bed is available and appropriate for this patient

Notify both sending and receiving care teams