Philadelphia Pennsylvania Modelo de carta para la terminación de la atención del médico - Paciente a médico - Sample Letter for Termination of Physician's Care - Patient to Physician

• Category: Cartas - No legales - Terminación
• State: Multi-State
• County: Philadelphia
• Control #: US-0237LR
• Format: Word

Description

Carta del paciente al médico dando por terminada la atención del médico. [Your Name] [Your Address] [City, State, Zip Code] [Email Address] [Phone Number] [Current 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 physician-patient relationship effectively immediately. After careful consideration and consulting with other healthcare providers, I have decided to pursue medical care elsewhere. I want to express my gratitude for the care and attention you have provided me up until now. Your expertise and dedication to your profession have been appreciated. However, as my healthcare needs have evolved, I believe that seeking alternative medical care is in my best interest. Please consider this letter as my official notice of termination. I kindly request that you transfer all relevant medical records pertaining to my treatment to the following healthcare provider: [Name of New Healthcare Provider] [New Provider's Address] [City, State, Zip Code] Furthermore, I would appreciate it if you could provide me with a summary of my medical history, including diagnoses, treatment plans, recent test results, and any other pertinent information that would assist my new healthcare provider in providing me with optimal care. I understand that there may be some administrative costs associated with the transfer of medical records, and I am prepared to fulfill any necessary financial obligations. Furthermore, I genuinely value the trust and rapport we have built during our time together, and I hope that our professional paths may cross again someday. However, at this point, I believe it is crucial for me to explore other medical options. If you have any questions or require additional information from me, please feel free to contact me at the phone number or email address provided above. I anticipate a smooth transition of my medical records and appreciate your prompt attention to this matter. Thank you again for your time, support, and commitment to my well-being. I wish you all the best in your future endeavors. Sincerely, [Your Name]

[Your Name] [Your Address] [City, State, Zip Code] [Email Address] [Phone Number] [Current 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 physician-patient relationship effectively immediately. After careful consideration and consulting with other healthcare providers, I have decided to pursue medical care elsewhere. I want to express my gratitude for the care and attention you have provided me up until now. Your expertise and dedication to your profession have been appreciated. However, as my healthcare needs have evolved, I believe that seeking alternative medical care is in my best interest. Please consider this letter as my official notice of termination. I kindly request that you transfer all relevant medical records pertaining to my treatment to the following healthcare provider: [Name of New Healthcare Provider] [New Provider's Address] [City, State, Zip Code] Furthermore, I would appreciate it if you could provide me with a summary of my medical history, including diagnoses, treatment plans, recent test results, and any other pertinent information that would assist my new healthcare provider in providing me with optimal care. I understand that there may be some administrative costs associated with the transfer of medical records, and I am prepared to fulfill any necessary financial obligations. Furthermore, I genuinely value the trust and rapport we have built during our time together, and I hope that our professional paths may cross again someday. However, at this point, I believe it is crucial for me to explore other medical options. If you have any questions or require additional information from me, please feel free to contact me at the phone number or email address provided above. I anticipate a smooth transition of my medical records and appreciate your prompt attention to this matter. Thank you again for your time, support, and commitment to my well-being. I wish you all the best in your future endeavors. Sincerely, [Your 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.