| 1. How have you been since your discharge? |
| 2. Can you tell if you had to go to ER or got admitted during this past month? |
| 3. If yes, ask: what was your main complaint for seeking healthcare? If hospitalized, ask about the length of stay in days. |
| 4. Where did you receive the unplanned care? (KKUH, or other facilities) |
| 5. Were there any changes to your medications? Document the changes. |
| 6. Have you seen your care provider in the outpatient clinic? |
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