Template
An aftercare handover record for medical travel: a blank template
A blank record to fill in before a patient flies home: what travels with them, who owns each item, and what stays open.
A template to adapt, not legal or clinical advice. Last checked .
01
What this template is
This is a blank record for the day an international patient leaves. It lists the records that must travel home and who owns each one. It shows how the patient got them, and what is still open. Print it, or copy the fields into your own system.
It is a template to adapt. It is not legal or clinical advice. What the clinical records say, and whether the patient is ready to travel, is decided by the treating clinician. This form records who decided, never what.
02
Why a handover record matters
The CDC Yellow Book tells clinicians to remind medical tourists "to request copies of their overseas medical records in English" and to share them with the professionals they see later. It reports that the American College of Surgeons advises travellers to "obtain a complete set of medical records before returning home". The NHS warns that overseas clinics "may not provide follow-up treatment".
In India, the NABH standard for medical travel facilitators asks about "Follow up services upon return". NABH is the national accreditation board for hospitals. Its follow-up plan includes "liaison between local physician and treating consultant when required".
A written handover is a promise that a patient in another country can hold an Indian provider to. The trade-off is a slower departure day, because each item is checked as received. In my judgement a message marked sent is not enough, and the extra hour is worth it.
03
How to fill it in
Start the record when the stay is booked, not on the last day. List anything unfinished as an open action with an owner, never as a tick.
Handover details
Patient reference and departure date
Use the service's own reference. Copy no more personal detail than the record needs. Basis: field note
Handover owner
The person in operations who keeps this record and closes it. Basis: field note
Responsible clinician
Name and role of the clinician who confirms what the records must contain. Basis: field note
Follow-up arrangement
Where follow-up will happen
Tick one. A plan to arrange support is not a confirmed appointment. Basis: field note
- With the treating service
- At an agreed local appointment
- Still being arranged (list it as an open action)
Follow-up route after return
How contact will happen, for example a video consultation if the service offers one. Basis: NABH MVTF standard
Records shared with later carers
Remind the patient to give the records to anyone who sees them for follow-up. Basis: CDC Yellow Book
Document register
Records that travel home
One row per record. The clinical author approves the content; operations tracks delivery. Basis: field note
| Record | Approved by | Version | In English | Sent by | Opened by patient |
|---|---|---|---|---|---|
| Record, row 1 | Approved by, row 1 | Version, row 1 | In English, row 1 | Sent by, row 1 | Opened by patient, row 1 |
| Record, row 2 | Approved by, row 2 | Version, row 2 | In English, row 2 | Sent by, row 2 | Opened by patient, row 2 |
| Record, row 3 | Approved by, row 3 | Version, row 3 | In English, row 3 | Sent by, row 3 | Opened by patient, row 3 |
| Record, row 4 | Approved by, row 4 | Version, row 4 | In English, row 4 | Sent by, row 4 | Opened by patient, row 4 |
| Record, row 5 | Approved by, row 5 | Version, row 5 | In English, row 5 | Sent by, row 5 | Opened by patient, row 5 |
| Record, row 6 | Approved by, row 6 | Version, row 6 | In English, row 6 | Sent by, row 6 | Opened by patient, row 6 |
Translation approved by
If a record is translated, name who approved its clinical meaning. Basis: field note
Ready, received, reachable
Ready
Every required record is approved, and open items are listed below. Basis: field note
Received
The patient opened each record through the approved channel. Note any access problem and how it was fixed. Basis: field note
Reachable
The contact route, its stated hours, and the person who keeps it working. Basis: field note
Help outside those hours
Copy the instructions the clinical team set. Operations does not write them. Basis: field note
Open actions after departure
Open actions
Each unfinished item with a named owner. If the owner changes, the new owner confirms it here. Basis: field note
| Action | Owner | Next contact | Escalate if no answer by |
|---|---|---|---|
| Action, row 1 | Owner, row 1 | Next contact, row 1 | Escalate if no answer by, row 1 |
| Action, row 2 | Owner, row 2 | Next contact, row 2 | Escalate if no answer by, row 2 |
| Action, row 3 | Owner, row 3 | Next contact, row 3 | Escalate if no answer by, row 3 |
| Action, row 4 | Owner, row 4 | Next contact, row 4 | Escalate if no answer by, row 4 |
Changes and gaps
Corrections issued
Which version replaces which, and who received the correction. Basis: field note
Missing at departure
Name the missing item, its owner, and what it means for the handover. Basis: field note
Decision on care or travel
Recorded by the responsible clinical team. Operations cannot certify that a patient is ready to travel. Basis: field note
Cost of any extra service
Who can explain the terms, so payment never decides which clinical question is answered. Basis: field note
Sign-off
Receipt confirmed by the patient
Signature or written confirmation, with the date. Basis: field note
Handover owner
Signature and date. The record stays open until every action above is closed. Basis: field note
Why each field matters is set out in the field note Medical tourism aftercare: the records that must travel home
A record filled in this way lets a patient abroad see what support was agreed and who answers for it. That is how an Indian provider shows its care does not end at the airport.