The document provides background information on a patient including their age, gender, medical history, social factors, and recent changes in condition. It also includes a physician SBAR (Situation-Background-Assessment-Recommendation) form which notes the problem being called about, the patient's current condition and any changes, recommendations for necessary interventions and care, anticipated changes, and education or discharge instructions.

1. Background
Patient's age: ________________________________________________________________ Gender:_______________________________________
Relevant medical history: ___________________________________________________________________________________________________
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Social or environmental factors impacting the patient's care: __________________________________________________________
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Recent changes in the patient's condition or clinical status: ____________________________________________________________
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Relevant laboratory or diagnostic test results: ___________________________________________________________________________
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Physician SBAR
Situation
I am calling about: _________________________________________________________________________________________(patient’s name)
The problem I am calling about is: _________________________________________________________________________________________
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Assessment
Patient's current condition: __________________________________________________________________________________________________
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Changes since the last assessment: ______________________________________________________________________________________
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Recommendation
Necessary medical interventions: __________________________________________________________________________________________
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Specific recommendations for the patient's care: ________________________________________________________________________
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Anticipated changes in the patient's care: ________________________________________________________________________________
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Education or discharge instructions for the patient or family members: _______________________________________________
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