Skip to content
Apex Nursing

Printable — Clinical Form

SBAR Handoff Form

A structured Situation–Background–Assessment–Recommendation template with prompts in each section. Use it to organize handoff report or to script a provider call before you dial.

Letter · portrait · prints without site navigation
Version
DetailedSimple
Fill it in on this device — autosaves, no account needed
SBAR Handoff / Provider CallDate / Time ______________
Patient ____________Room ____________From (RN) ____________To ____________
S

Situation

Who you are · who the patient is · the problem right now — “I’m calling because…” One or two sentences.

B

Background

Admitting diagnosis · relevant history · code status · current meds, drips, and treatments that matter to this problem.

A

Assessment

Latest vitals · focused exam findings · what has changed · what you think is going on.

R

Recommendation

What you need — orders requested, labs or imaging, a bedside evaluation · what to monitor · when to call back.

New orders received Read-back completed DocumentedTime ________
Questions I still have / follow-up

Apex Nursing · apex-nursing.com — educational template; verify against facility policy. Not part of the medical record.

Educational use only. This template supports communication practice — escalate per your facility’s chain of command and document in the approved system. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.