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

State:
Multi-State
Control #:
US-0237LR
Format:
Word; 
Rich Text
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Description

This form is a sample letter in Word format covering the subject matter of the title of the form.

[Your Name] [Your Address] [City, State, ZIP] [Email Address] [Phone Number] [Date] [Physician's Name] [Physician's Address] [City, State, ZIP] Subject: Termination of Physician's Care Dear Dr. [Physician's Last Name], I hope this letter finds you in good health. I am writing to inform you of my decision to terminate our physician-patient relationship effective immediately. As a resident of Delaware, I believe it is essential to seek medical care that aligns with my specific healthcare needs and personal preferences. After careful consideration and consultation with other healthcare professionals, I have decided to explore alternative options for my medical care that more closely match my evolving health concerns. It is not a reflection of your abilities or the quality of care you have provided to me thus far. During our time together, I have appreciated the level of attention and expertise you have demonstrated. However, due to personal reasons, I believe it is in my best interest to pursue a different medical path at this time. I have found a new healthcare provider who specializes in the specific areas that I feel are crucial to my wellbeing. I kindly request that you transfer my medical records, including all pertinent documents, test results, and imaging reports, to the following healthcare provider: [New Physician's Name] [New Physician's Address] [City, State, ZIP] I authorize you to release my medical records to the designated physician's office within a reasonable timeframe conforming to legal requirements. If any fees or costs are associated with the transfer of my medical records, please inform me in writing or via telephone before proceeding, as required under Delaware law. I would also appreciate it if you could inform me of any pending test results or ongoing medical treatments that should be conveyed to my new healthcare provider. This information will significantly contribute to the continuity of my care during this transition period. I thank you for your understanding and the level of care you have provided to me throughout our association. I have attached a signed release form, complying with all HIPAA regulations, allowing you to transfer my medical records promptly. Please acknowledge your receipt of this letter and provide written confirmation of both the transfer of my medical records and the completion of this termination of care process. If at any point in the future I require medical care that falls within your area of expertise, I will not hesitate to contact your office for an appointment. I hold your professional opinion and expertise in high regard. Thank you once again for your assistance, and I wish you and your team continued success in your medical practice. Sincerely, [Your Name]

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FAQ

This letter is to advise you that I will no longer be available to provide medical services to you after (FUTURE DATE ALLOWING PATIENT REASONABLE TIME TO FIND ANOTHER PHYSICIAN). I will be available to treat you until (DATE FROM ABOVE), so that you will have access to care while you choose another physician.

In general, the physician-patient relationship can be terminated in two ways without creating liability for abandonment: 1) the physician ends the relationship after giving the patient notice, a reasonable opportunity to find substitute care and the information necessary to obtain the patient's medical records, or 2)

Doctors' notes, test results and other information will be useful to your new doctor. If you feel the need to discuss your reason for leaving, take a thoughtful and compassionate approach as you would any breakup. You can be honest with your feedback without being rude.

How Can I End the Patient/Physician Relationship? You can end the patient/physician relationship by explicitly telling your doctor that you no longer want to be treated by him or her.

Appropriate and Ethical The first step is to notify the patient that you will no longer be treating him. Although laws vary by state, most statutes mandate a reasonable notification time period. To be safe, you should give the patient at least 30 days' notice.

When a physician-patient relationship must be terminated, the physician must carefully document the circumstances in the patient's medical record. This termination note should review the patient's previous medical treatment and the current state of the patient's health.

In general, the physician-patient relationship can be terminated in two ways without creating liability for abandonment: 1) the physician ends the relationship after giving the patient notice, a reasonable opportunity to find substitute care and the information necessary to obtain the patient's medical records, or 2)

The physician terminates the physician-patient relationship by notifying the patient in writing of withdrawal from care after a specific time which is stated in the letter. The patient is also given information necessary to obtain their medical records or transfer to another provider.

When a physician decides to dismiss a patient, the patient should be notified in writing. The letter should be printed on office letterhead and sent by first-class mail and by certified mail with a return receipt requested.

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1.1.5 Terminating a Patient-Physician Relationship(a) The patient requests care that is beyond the physician's competence or scope of practice; ...18 pages 1.1.5 Terminating a Patient-Physician Relationship(a) The patient requests care that is beyond the physician's competence or scope of practice; ... If it becomes necessary to end a patient relationship that is no longerIf the provider is the only source of medical or dental care within a reasonable ...DHSS reserves the right to recommend or decline any request for a waiver. 3.7 The Delaware Division of Public Health shall charge a non-refundable processing ... The termination of health care was contrary to the patient's will or withoutPhysicians, nurses, and other health care professionals have an ethical, ... The CAH keeps the original form on file. When CAHs elect the Optional Payment Method, it stays in effect until the CAH submits a termination request. We don't ...11 pages The CAH keeps the original form on file. When CAHs elect the Optional Payment Method, it stays in effect until the CAH submits a termination request. We don't ... They are required to use a team approach of physicians working withCan Rural Health Clinics be certified as Patient-Centered Medical Homes (PCMHs)? ... (h) Physicians using telemedicine technologies to provide medical care to patients located in Delaware must, prior to a diagnosis and treatment, ... The patient cost estimator does not apply to any Aetna® Medicare Advantage plans.physicians, health care professionals, hospitals, facilities.72 pages The patient cost estimator does not apply to any Aetna® Medicare Advantage plans.physicians, health care professionals, hospitals, facilities. By EJ Emanuel · Cited by 1 ? the patient's health or ameliorate pain.at the time or later, to the physician's de¬model, the objective of the physician- patient interaction is ... The more ?medical? the patient's contact with the doctor's office isongoing care is terminated by the doctor without adequate notice to ...

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