Subject: [Patient Name]'s Termination of Physician's Care Agreement Dear Dr. [Physician's Last Name], I hope this letter finds you well. I am writing to formally terminate our physician-patient relationship effective immediately. After thoughtful consideration and discussion with my family, I have made the difficult decision to seek medical care elsewhere. I am grateful for the medical attention you have provided me until now, but believe that this change is in my best interest. Hillsborough County, Florida, where we reside, offers a wide range of healthcare providers with various specialties that suit my evolving medical needs. While I acknowledge the value of continuity in patient-physician relationships, I believe it is crucial for me to explore alternatives that align with my current health concerns and objectives. I would like to express my deep appreciation for your care, compassion, and dedication shown to me throughout our medical journey together. Your expertise and professionalism have been truly admirable, and your commitment to my well-being has been evident at every step. To ensure a seamless transition, I kindly request that you provide me with copies of my medical records, including any relevant test results and treatment plans. Please also include any specialist referrals, medication prescriptions, and vaccination records that may be applicable. These records will greatly assist me in establishing continuity of care with my new healthcare provider. Should I encounter any difficulties in securing my medical records, I kindly request your assistance or guidance in resolving any potential obstacles. Please inform me of your preferred method of record transfer or if there are any administrative fees associated with this process. While discontinuing our physician-patient relationship, I remain confident in your abilities as a healthcare professional and hold no grievances or claims against you or your practice. This decision is solely based on my personal circumstances and evolving medical requirements. You're understanding and cooperation in this matter are greatly appreciated. I am grateful for the care I have received and the professional relationship we have had over the years. I wish you all the best in your future endeavors and hope that you continue to have a positive impact on your patients' lives. Thank you for your attention to this matter. May you and your practice thrive and continue to provide excellent medical care to those who need it. Sincerely, [Patient Name] [Date] Note: There is no specific categorization or specific types of Hillsborough Florida Sample Letter for Termination of Physician's Care — Patient to Physician mentioned.
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.