FOLLOW-UP AFTER DISCHARGE Your social worker and the rehabilitation team will explore the answers to these questions with you. For additional information, refer to the chapter on Community Resources. 1. What contact will you have with the medical center or another hospital after discharge? ______________________________________________________________________________ ______________________________________________________________________________ 2. How will you get appointments and who will pay for them? 'Individual (you personally)          'Organization or government agency Organization: __________________________________________________________________ Contact Person: ______________________________________ Phone: (_____)_____________ 3. Will outreach staff from local community agencies visit you after discharge? 'Yes     'No If so, who? ____________________________________________________________________ 4. If you need help with your daily routine, who will be available? Organization: __________________________________________________________________ Contact Person: ______________________________________ Phone: (_____)_____________ Organization: __________________________________________________________________ Contact Person: ______________________________________ Phone: (_____)_____________ 5. What community agencies will provide services after discharge? Organization: __________________________________________________________________ Contact Person: ______________________________________ Phone: (_____)_____________ Organization: __________________________________________________________________ Contact Person: ______________________________________ Phone: (_____)_____________ 6. How will you travel home? ______________________________________________________________________________ 7. Who will pay for and arrange your travel plans? 'Individual (you personally)          'Organization or government agency Organization: __________________________________________________________________ Contact Person: ______________________________________ Phone: (_____)_____________ 8. Do you know whom to call if you have a problem at home? Name: ______________________________________________ Phone: (_____)_____________