Wayne Michigan 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: Wayne
• Control #: US-0237LR
• Format: Word

Description

Carta del paciente al médico dando por terminada la atención del médico. Subject: Formal Termination of Physician's Care — Patient to Physician [Your Name] [Your Address] [City, State, ZIP] [Email Address] [Phone Number] [Date] [Physician's Name] [Physician's Address] [City, State, ZIP] Dear Dr. [Physician's Last Name], I hope this letter finds you well. I am writing with the regrettable news that I will be terminating our professional relationship as my primary care physician effective [termination date — usually 30 days from the date of this letter]. After careful consideration and discussion with my family, I believe it is in my best interest to seek medical care elsewhere. I would like to express my sincere appreciation for the medical attention and support you have provided me throughout our time together. Your dedication, expertise, and commitment to my wellbeing have not gone unnoticed, and I am truly grateful for the care I have received under your guidance. However, recent changes in my circumstances, location, or insurance network have compelled me to explore other options for healthcare services that can better accommodate my needs. As a resident of Wayne, Michigan, I am seeking a physician who is more conveniently located and who accepts my current insurance. While your medical expertise has been invaluable, please understand that this decision is purely driven by personal factors and does not reflect any dissatisfaction with the quality of care I have received. I have full confidence in your abilities and would not hesitate to recommend your services to others in need of medical attention. In light of our professional relationship coming to an end, I kindly request that you assist me during this transition period. To facilitate the transfer of my medical records to my new physician, I hereby authorize your office to release these records to the healthcare provider listed below: Name of New Physician: [New Physician's Name] Address: [New Physician's Address] City, State, ZIP Additionally, I kindly request that you provide me with a copy of my complete medical records, including test results, diagnoses, treatment plans, and any other pertinent information. Please inform me of any associated fees for this service or any additional procedure I need to follow to obtain these records. I will be scheduling an appointment with my new physician shortly and would appreciate it if you could ensure that all documents are available at that time. I understand that this process may take some time, so please do not hesitate to contact me should you require further information or if there are any complications in the record transfer. Thank you once again for your professionalism and commitment to my healthcare needs. I genuinely appreciate the care you have provided, and I wish you continued success in your medical practice. If circumstances permit, I may seek your services again in the future. Yours faithfully, [Your Name]

Subject: Formal Termination of Physician's Care — Patient to Physician [Your Name] [Your Address] [City, State, ZIP] [Email Address] [Phone Number] [Date] [Physician's Name] [Physician's Address] [City, State, ZIP] Dear Dr. [Physician's Last Name], I hope this letter finds you well. I am writing with the regrettable news that I will be terminating our professional relationship as my primary care physician effective [termination date — usually 30 days from the date of this letter]. After careful consideration and discussion with my family, I believe it is in my best interest to seek medical care elsewhere. I would like to express my sincere appreciation for the medical attention and support you have provided me throughout our time together. Your dedication, expertise, and commitment to my wellbeing have not gone unnoticed, and I am truly grateful for the care I have received under your guidance. However, recent changes in my circumstances, location, or insurance network have compelled me to explore other options for healthcare services that can better accommodate my needs. As a resident of Wayne, Michigan, I am seeking a physician who is more conveniently located and who accepts my current insurance. While your medical expertise has been invaluable, please understand that this decision is purely driven by personal factors and does not reflect any dissatisfaction with the quality of care I have received. I have full confidence in your abilities and would not hesitate to recommend your services to others in need of medical attention. In light of our professional relationship coming to an end, I kindly request that you assist me during this transition period. To facilitate the transfer of my medical records to my new physician, I hereby authorize your office to release these records to the healthcare provider listed below: Name of New Physician: [New Physician's Name] Address: [New Physician's Address] City, State, ZIP Additionally, I kindly request that you provide me with a copy of my complete medical records, including test results, diagnoses, treatment plans, and any other pertinent information. Please inform me of any associated fees for this service or any additional procedure I need to follow to obtain these records. I will be scheduling an appointment with my new physician shortly and would appreciate it if you could ensure that all documents are available at that time. I understand that this process may take some time, so please do not hesitate to contact me should you require further information or if there are any complications in the record transfer. Thank you once again for your professionalism and commitment to my healthcare needs. I genuinely appreciate the care you have provided, and I wish you continued success in your medical practice. If circumstances permit, I may seek your services again in the future. Yours faithfully, [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.