The patient states they want to leave because “***”. The risks of leaving against medical advice without further workup were explained to the patient. The patient demonstrated good understanding and was able to verbalize in their own words the risks of leaving up to, and including, death or permanent disability. While I do not agree with their decision, their thought process is goal directed. Their speech is appropriate and mental status is normal. The patient has not demonstrated any SI. The decision appears to be consistent with what limited knowledge I have of the patient’s values. The patient has capacity to make the decision to leave against medical advice. The patient was informed that we are always happy to care for them and that they are always welcome to return at any time. The patient understands the warning signs and symptoms that should prompt them to seek immediate emergency care.