Illinois Sample Letter for Termination of Physician's Care — Patient to Physician Subject: Termination of Care — [Patient's Name] [Date] [Physician's Name] [Physician's Address] [City, State, ZIP Code] Dear Dr. [Physician's Last Name], I hope this letter finds you well. I am writing to inform you of my decision to terminate our doctor-patient relationship effective immediately. I sincerely appreciate the care and support you have provided to me during our time working together. However, after careful consideration, I have decided to seek medical treatment from another physician for my ongoing healthcare needs. As an active participant in my healthcare, it is crucial for me to have confidence in the medical care and treatment I receive. Regrettably, I feel that my current medical needs are not being adequately met, and I believe it is in my best interest to explore other options. It is important to note that this decision is not a reflection of your medical expertise or commitment, but rather a personal choice based on my need for a different approach to my healthcare. I kindly request that you transfer my medical records to my new healthcare provider as soon as possible. Additionally, please include any pertinent information, such as test results, diagnoses, treatment plans, and medication prescriptions. Ensuring the seamless continuation of my medical care is of utmost importance to me. I understand that as a healthcare professional, you have an obligation to maintain the confidentiality of my medical information. Therefore, I trust that my records will be handled with the utmost care and in compliance with all applicable privacy laws. I would like to express my gratitude for the medical care you have provided to me up until this point. Your expertise and dedication have been invaluable. Please know that this decision was not made lightly, and I hope you understand and respect my choice. Should I require medical care in the future and feel the need to reestablish our doctor-patient relationship, I will not hesitate to reach out to your office. Thank you again for your understanding. Wishing you all the best in your future endeavors. Sincerely, [Patient's Name] [Patient's Address] [City, State, ZIP Code] Keywords: Illinois sample letter, termination of physician's care, patient to physician, doctor-patient relationship, seeking new medical treatment, medical records transfer, medical information confidentiality, gratitude for medical care, future doctor-patient relationship.
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.