Dear [Physician's Name], I hope this letter finds you well. I am writing to inform you about my decision to terminate my current physician's care with your practice. First, I want to express my gratitude for the care and attention you have provided over the course of our professional relationship. Your expertise and dedication to patient care have greatly contributed to my overall well-being, and I am thankful for the time we have spent together. However, due to recent changes in my personal circumstances, I have made the difficult decision to seek medical care closer to home. As you are aware, I currently reside in Phoenix, Arizona, and the distance to your office has become a significant inconvenience for me in terms of transportation and time management. Therefore, I believe it is in my best interest to find a physician within the local Phoenix area who can provide the necessary medical care more conveniently. It is important for me to have a healthcare professional nearby, especially in cases of emergencies or unexpected medical needs. I understand that the transition process may require certain medical documentation to be transferred to my new physician. I kindly request your assistance in this matter to ensure a smooth transfer of my medical records. If there are any specific procedures or forms that need to be completed for this purpose, please inform me as soon as possible. I would like to schedule one final appointment with you to discuss the termination process and any ongoing treatments or prescriptions that may require adjustments. This will also give us an opportunity to address any questions or concerns I may have before concluding our patient-physician relationship. I truly appreciate the level of care you have consistently shown me, and it is with a heavy heart that I make this decision. Please understand that it is solely based on logistical considerations, and I have the utmost respect and admiration for your medical expertise. Thank you again for your valuable guidance and support throughout our time together. I wish you continued success in your medical practice. Sincerely, [Your Name] [Your 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.