Dear [Physician's Name], I hope this letter finds you well. I am writing to discuss an important matter regarding my healthcare. After careful consideration and review of my medical needs, I have made the difficult decision to terminate our physician-patient relationship effective immediately. Firstly, I want to express my gratitude for the care you have provided me up until this point. Your dedication, expertise, and commitment to my well-being have not gone unnoticed. However, due to personal circumstances, I believe it is in my best interest to seek medical care elsewhere. As I am sure you are aware, finding the right healthcare provider is crucial for any individual's well-being. After thorough research and conversations with trusted friends and family, I have identified a new physician who aligns closely with my specific medical needs and preferences. This decision has not been taken lightly, and I believe it will allow me to receive the personalized care I am seeking. Regarding the transition of my medical records, I kindly request your assistance in transferring all relevant documentation to my new healthcare provider. I understand that this process may involve signing necessary release forms or providing your office with contact information for the new physician. I expect your prompt assistance in ensuring a smooth transfer, as this is essential for the continuity of my healthcare. In the meantime, I would appreciate your guidance on any ongoing treatments, prescriptions, or recommended specialist referrals that I should be aware of before my transition to the new provider. It is crucial for me to maintain consistency in my care during this period of change. While my decision to terminate our physician-patient relationship may come as a surprise, I want to reassure you that it is not a reflection of the quality of care provided by your esteemed practice. Personal circumstances and preferences have driven my decision, and I genuinely appreciate the care and attention you have given me throughout our time working together. Thank you again for your understanding, and I wish you all the best in your medical practice. If you have any questions or require further information, please do not hesitate to contact me at [your contact information]. 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.