Dear [Physician's Name], I hope this letter finds you well. I am writing to inform you of my decision to terminate our physician-patient relationship, effective immediately. This decision is not one that I have taken lightly and comes after careful consideration and discussion with my loved ones. Firstly, I would like to express my sincerest gratitude for the care and support you have provided me throughout our time together. Your expertise and commitment to my well-being have been invaluable, and I am truly appreciative of the medical attention you have given me. However, after much thought, I have chosen to pursue alternative medical options for my condition. [Explain the reasons for seeking a new physician or medical approach, such as a desire for a second opinion, relocation, change in insurance coverage, or personal preferences.] I want to emphasize that this decision is in no way a reflection of your skills as a physician or the quality of care you provide. It is simply a personal choice that I believe will be best for my health journey moving forward. Please consider this as my formal request to obtain my medical records from your office. Due to privacy regulations, I am aware that a signed release form may be necessary for the transfer of these records. Kindly inform me of the necessary steps or paperwork required for this process. I would also greatly appreciate any recommendations or referrals you may have for other healthcare professionals that specialize in [your medical condition or area of concern]. Your expertise and knowledge of the medical community in Hawaii would be of immeasurable value in guiding me towards the most suitable healthcare provider. Lastly, I would like to thank you again for your dedication and care during our time together. Your professionalism and compassion have made a significant impact on me, and I am grateful for the positive experiences I have had under your watchful eye. Should circumstances change, or I find myself in need of medical care in the future, I will not hesitate to consider your services once again. I wish you all the best in your continued practice and future endeavors. Thank you for your understanding and cooperation. Sincerely, [Your Name] [Your Contact Information]
Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.