Subject: Notice of Termination of Physician's Care — Physician to Patient [Your Practice Name] [Address] [City, State, ZIP] [Phone Number] [Email Address] [Date] [Patient's Name] [Address] [City, State, ZIP] Dear [Patient's Name], RE: Termination of Physician's Care I hope this letter finds you well. We would like to inform you that, after careful consideration and review of your medical situation, we have made the difficult decision to discontinue providing medical care to you as of [Termination Date]. This decision was reached after extensive discussions within our medical team and taking into account various factors that impact the quality and efficacy of our professional relationship. At [Your Practice Name], we prioritize the well-being and satisfaction of our patients, and we believe that it is essential to maintain a mutually beneficial physician-patient relationship. Unfortunately, for reasons we have outlined below, we find it necessary to terminate our association as your healthcare provider: 1. [Reason 1]: Please provide a detailed explanation of the reason for termination. For example, ongoing non-compliance with prescribed treatments or failure to schedule follow-up appointments. 2. [Reason 2]: Elaborate on any additional concerns or issues that have influenced this decision. For instance, if the patient has exhibited disrespectful behavior or has engaged in actions that compromise their own or others' safety. The decision to terminate care is not taken lightly, and it is made after exhausting all reasonable efforts to address the concerns promptly and effectively. We firmly believe that finding another healthcare provider who aligns better with your needs will be in your best interest and will contribute to the overall success of your ongoing medical care. To ensure a smooth transition, we kindly request that you take the necessary steps to secure alternative healthcare as soon as possible. We recommend promptly contacting your insurance provider or utilizing local resources to obtain a referral to a reputable physician who can assist you with your medical needs seamlessly. Until [Termination Date], our office will remain available to provide emergency medical care or any essential medical records to your new healthcare provider upon your signed authorization. Please contact us at [Phone Number] or [Email Address] if you require any assistance or have questions regarding the transition. We genuinely appreciate the trust you have placed in us as your healthcare provider and hope that you find another physician who will meet your needs effectively. We wish you all the best for your future health and wellness. Sincerely, [Physician's Name] [Physician's Title] [Your Practice Name]
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.