• US Legal Forms

District of Columbia Sample Letter for Termination of Physician's Care - Physician to Patient

State:
Multi-State
Control #:
US-0236LR
Format:
Word; 
Rich Text
Instant download

Description

Sample Letter for Termination of Physician's Care - Physician to Patient [Your Name] [Your Address] [City, State, ZIP] [Email Address] [Phone Number] [Date] [Patient's Name] [Patient's Address] [City, State, ZIP] Dear [Patient's Name], RE: TERMINATION OF PHYSICIAN'S CARE I hope this letter finds you in good health. I am writing to inform you that after careful consideration and evaluation of your medical history and current condition, I have made the difficult decision to terminate our physician-patient relationship, effective [insert termination date thirty (30) days from the date of this letter]. This decision is not made lightly and is primarily based on a comprehensive assessment of your medical needs, the scope of my practice, and the complexities involved in providing appropriate care for your specific condition. It is important to note that this termination does not stem from any personal or discriminatory factors but rather serves as a professional decision made in your best interest. As your primary care physician, I have a strong commitment to providing quality care and ensuring the well-being of my patients. However, in your case, I believe that it is in your best interest to seek specialized care from a medical professional who possesses the expertise and resources necessary to effectively address your specific medical needs. Choosing an appropriately qualified specialist will not only result in more customized and efficient treatment but also enhance the likelihood of positive health outcomes. I have attached a list of recommended specialists whom you may consider for further evaluation and treatment of your condition. During the transition period until the termination date indicated above, I am obliged to provide you with limited medical care. However, I encourage you to proactively initiate the process of establishing care with a new physician to ensure a seamless continuation of your medical management. To facilitate this, I authorize the release of your medical records upon receipt of a signed consent form from you or your new healthcare provider. To request your medical records, please complete and sign the enclosed Medical Records Request Form and return it to my office. Once received, we will promptly forward your records to your designated healthcare provider. In the event that you require emergency medical attention during this transition period, please seek immediate assistance at the nearest emergency department or call 911. Please be aware that I am available for any questions or concerns you may have regarding this transition process or your ongoing medical care until the termination date. I am committed to ensuring a smooth transfer of your healthcare to a new medical professional and will assist in any way possible. I genuinely appreciate the trust and confidence you have placed in me as your healthcare provider thus far, and I regret any inconvenience this decision may cause. My ultimate goal is to ensure you receive the highest standard of care that aligns with your specific medical needs. Thank you for your understanding and cooperation throughout this process. I wish you the very best in your continued journey towards improved health and well-being. Sincerely, [Your Name] [Your Title/Position] [Your Medical Practice Name] [Your Medical Practice Address] [City, State, ZIP] [Phone Number] [Email Address] --- Keyword: District of Columbia Sample Letter for Termination of Physician's Care — Physician to Patient Additional types of District of Columbia Sample Letter for Termination of Physician's Care — Physician to Patient can include: 1. District of Columbia Sample Letter for Termination of Specialist's Care — Specialist to Patient 2. District of Columbia Sample Letter for Termination of Therapist's Care — Therapist to Patient 3. District of Columbia Sample Letter for Termination of Psychologist's Care — Psychologist to Patient 4. District of Columbia Sample Letter for Termination of Dentist's Care — Dentist to Patient 5. District of Columbia Sample Letter for Termination of Optometrist's Care — Optometrispatientnnnnnnnnnt.nt

[Your Name] [Your Address] [City, State, ZIP] [Email Address] [Phone Number] [Date] [Patient's Name] [Patient's Address] [City, State, ZIP] Dear [Patient's Name], RE: TERMINATION OF PHYSICIAN'S CARE I hope this letter finds you in good health. I am writing to inform you that after careful consideration and evaluation of your medical history and current condition, I have made the difficult decision to terminate our physician-patient relationship, effective [insert termination date thirty (30) days from the date of this letter]. This decision is not made lightly and is primarily based on a comprehensive assessment of your medical needs, the scope of my practice, and the complexities involved in providing appropriate care for your specific condition. It is important to note that this termination does not stem from any personal or discriminatory factors but rather serves as a professional decision made in your best interest. As your primary care physician, I have a strong commitment to providing quality care and ensuring the well-being of my patients. However, in your case, I believe that it is in your best interest to seek specialized care from a medical professional who possesses the expertise and resources necessary to effectively address your specific medical needs. Choosing an appropriately qualified specialist will not only result in more customized and efficient treatment but also enhance the likelihood of positive health outcomes. I have attached a list of recommended specialists whom you may consider for further evaluation and treatment of your condition. During the transition period until the termination date indicated above, I am obliged to provide you with limited medical care. However, I encourage you to proactively initiate the process of establishing care with a new physician to ensure a seamless continuation of your medical management. To facilitate this, I authorize the release of your medical records upon receipt of a signed consent form from you or your new healthcare provider. To request your medical records, please complete and sign the enclosed Medical Records Request Form and return it to my office. Once received, we will promptly forward your records to your designated healthcare provider. In the event that you require emergency medical attention during this transition period, please seek immediate assistance at the nearest emergency department or call 911. Please be aware that I am available for any questions or concerns you may have regarding this transition process or your ongoing medical care until the termination date. I am committed to ensuring a smooth transfer of your healthcare to a new medical professional and will assist in any way possible. I genuinely appreciate the trust and confidence you have placed in me as your healthcare provider thus far, and I regret any inconvenience this decision may cause. My ultimate goal is to ensure you receive the highest standard of care that aligns with your specific medical needs. Thank you for your understanding and cooperation throughout this process. I wish you the very best in your continued journey towards improved health and well-being. Sincerely, [Your Name] [Your Title/Position] [Your Medical Practice Name] [Your Medical Practice Address] [City, State, ZIP] [Phone Number] [Email Address] --- Keyword: District of Columbia Sample Letter for Termination of Physician's Care — Physician to Patient Additional types of District of Columbia Sample Letter for Termination of Physician's Care — Physician to Patient can include: 1. District of Columbia Sample Letter for Termination of Specialist's Care — Specialist to Patient 2. District of Columbia Sample Letter for Termination of Therapist's Care — Therapist to Patient 3. District of Columbia Sample Letter for Termination of Psychologist's Care — Psychologist to Patient 4. District of Columbia Sample Letter for Termination of Dentist's Care — Dentist to Patient 5. District of Columbia Sample Letter for Termination of Optometrist's Care — Optometrispatientnnnnnnnnnt.nt

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District of Columbia Sample Letter for Termination of Physician's Care - Physician to Patient