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

• Category: Letters - Nonlegal - Termination
• State: Multi-State
• Control #: US-0237LR
• Format: Word; Rich Text

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]

[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]