What is an AMA discharge and when is it used?

AMA (Against Medical Advice) discharge occurs when a patient chooses to leave a healthcare facility before their treating physician recommends discharge. It requires documentation that the patient understands the risks of leaving, has decision-making capacity, and releases the facility from liability for adverse outcomes.

What must be documented for a valid AMA discharge?

Documentation must include: assessment of patient's decision-making capacity, specific risks of leaving explained to the patient, patient's understanding of those risks, that the patient was offered continued care, patient's stated reason for leaving, and signatures from patient, witness, and provider.

Can a patient who has been drinking or using drugs sign an AMA form?

Patients must have decision-making capacity to sign an AMA form. If intoxication impairs judgment, the patient may not have capacity. Document capacity assessment including orientation, understanding of condition and risks, and ability to communicate a clear choice. If capacity is questionable, consider psychiatric consultation.

What happens if a patient leaves without signing the AMA form?

If a patient leaves without signing, document the attempt to obtain signature, the patient's refusal, the risks explained, and that the patient left without completing documentation. Have a witness sign attesting to the events. This is sometimes called 'elopement' or 'left without being seen' (LWBS).

Does signing an AMA form protect the hospital from all liability?

No. An AMA form provides documentation of informed refusal but does not provide absolute legal protection. Courts may still find liability if the provider failed to adequately explain risks, didn't properly assess capacity, or if the form was signed under duress. Thorough documentation is the best protection.

AMA Discharge Form Template | Against Medical Advice Release

Quick-Use Checklist

Use this checklist before finalizing documentation.

Confirm visit context, chief concern, and date/time of service before note completion.

Capture required exam/findings and plan elements that support coding specificity.

Document medical decision making clearly to reduce denials and audit risk.

LEAVING AGAINST MEDICAL ADVICE (AMA) Patient Name: [Patient Name] DOB: [Date of Birth] Date/Time: [Date/Time] 1. Recommended Care:

The medical provider has recommended the following treatment/hospitalization:
[ ] Admission to Hospital
[ ] Emergency Treatment/Procedure: [Specify]
[ ] Medication/Observation

2. Risks of Refusal:

I understand that refusing this medical care may result in serious health consequences, including but not limited to:
[ ] Worsening of condition
[ ] Permanent disability
[ ] Loss of function/limb
[ ] Severe infection/sepsis
[ ] DEATH
[ ] Other: [Specific risks discussed]

3. Capacity:

The provider has determined that I have the medical decision-making capacity to understand these risks and make this choice. I am not under the influence of substances or a medical condition that impairs my judgment.

4. Patient Acknowledgement:

I, [Patient Name], strictly against the advice of my attending physician(s), am choosing to leave [Facility Name] or refuse recommended treatment. I assume full responsibility for any and all consequences of this decision. I release the hospital, its staff, and treating providers from liability for any adverse outcomes resulting from my refusal.

5. Return Instructions:

I understand I may return to this facility or another emergency department at any time if I change my mind or my condition worsens.

Signature of Patient/Rep: __________________________ Date: [Date] Relationship (if not patient): __________________________ Witness: __________________________ Date: [Date] Provider Name: [Provider Name]

Administrative — Against Medical Advice (AMA) Discharge Form

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