Dear [Physician's Name], I hope this letter finds you well. I am writing to express my sincere gratitude for the medical care and attention you have provided to me over the past [duration]. However, after careful consideration and discussion with my family, I have made the difficult decision to terminate our physician-patient relationship with you. I would like to emphasize that this decision is in no way a reflection of your skills, expertise, or professionalism. I have received exceptional care under your guidance and have always felt well-supported by you and your staff. My decision to seek medical assistance elsewhere is purely based on personal reasons and does not diminish my appreciation for the care you have provided. I have taken the necessary steps to find a new physician who aligns more closely with my current healthcare needs and preferences. After researching and consulting with trusted sources, I believe this change will be in my best interest moving forward. I kindly request that you help facilitate the smooth transition of my medical records to my new healthcare provider. As per my informed consent, I authorize the release of all relevant medical information to my new physician, ensuring continuity of care. Please provide me with the necessary forms or procedures to complete this process. I understand that you have a busy practice and my decision may be unexpected. Therefore, I am open to scheduling a final appointment to discuss any open medical concerns or to receive any pending test results. Please let me know if this would be convenient for you. I am sincerely grateful for the care and support you have provided to me. Although I am moving on from your practice, I will always hold the utmost respect and appreciation for the commitment you have shown towards my well-being. Thank you for your understanding and cooperation during this transition. I wish you continued success in your medical career. Yours sincerely, [Patient's Name] [Patient's 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.