This form is a sample letter in Word format covering the subject matter of the title of the form.
Subject: Request for Narrative Medical Report for Guam Medical Assessment Dear [Doctor's Name], I hope this letter finds you in good health. I am writing to kindly request your assistance in providing me with a detailed narrative medical report pertaining to my current medical condition for the purpose of a Guam Medical Assessment. I have recently been advised to submit a comprehensive report to proceed with the necessary legal procedures, and I would greatly appreciate your expertise in this matter. Furthermore, I have been a patient under your care since [specific date] and have consistently entrusted my health to your professional expertise. Throughout our doctor-patient relationship, you have demonstrated exceptional medical knowledge and understanding, offering me personalized care and treatment options. Considering the intricacies involved in the Guam Medical Assessment process, I kindly request that the narrative medical report include pertinent information such as: 1. Background Information: — Date of my first visit to your practice and subsequent follow-up visits. — Relevant personal and medical history, including any chronic conditions or previous surgeries. 2. Presenting Complaints: — Detailed description of the current medical condition that necessitates the Guam Medical Assessment. — Duration, severity, and progress of symptoms. 3. Assessment and Diagnoses: — Comprehensive examination and evaluation performed. — Differential diagnoses considered and reasons for eliminating or identifying specific conditions. — Diagnostic tests conducted, their results, and accompanying interpretations. — Any concurrent medications and their impact on the condition, if applicable. 4. Treatment Plan and Outcomes: — Outline of the treatment plan, including medications prescribed, dosage, and frequency. — Description of any surgical interventions, if warranted. — Response to treatment, including improvements, setbacks, or any adverse effects experienced. 5. Prognosis and Recommendations: — Expert opinion on the future course of the condition. — Specific recommendations for further investigations or consultations required, if any. — Any anticipated long-term effects, complications, or necessary lifestyle adjustments. Please ensure that the narrative medical report is addressed to me directly and includes your professional qualifications, clinic's contact details, and a signature confirming its authenticity. If there are any relevant medical records or test results that supplement the report, I would be grateful if you could include copies as well. Due to the time-sensitive nature of my requirements, I kindly request that you prioritize the completion of this narrative medical report within [reasonable timeframe]. If any fees apply for the preparation and provision of this report, please do let me know in advance. Thank you for your attention to this matter, and I appreciate your ongoing care and support. Should you have any questions or require further information, please do not hesitate to contact me. Yours sincerely, [Your Name] [Your Contact Information]
Subject: Request for Narrative Medical Report for Guam Medical Assessment Dear [Doctor's Name], I hope this letter finds you in good health. I am writing to kindly request your assistance in providing me with a detailed narrative medical report pertaining to my current medical condition for the purpose of a Guam Medical Assessment. I have recently been advised to submit a comprehensive report to proceed with the necessary legal procedures, and I would greatly appreciate your expertise in this matter. Furthermore, I have been a patient under your care since [specific date] and have consistently entrusted my health to your professional expertise. Throughout our doctor-patient relationship, you have demonstrated exceptional medical knowledge and understanding, offering me personalized care and treatment options. Considering the intricacies involved in the Guam Medical Assessment process, I kindly request that the narrative medical report include pertinent information such as: 1. Background Information: — Date of my first visit to your practice and subsequent follow-up visits. — Relevant personal and medical history, including any chronic conditions or previous surgeries. 2. Presenting Complaints: — Detailed description of the current medical condition that necessitates the Guam Medical Assessment. — Duration, severity, and progress of symptoms. 3. Assessment and Diagnoses: — Comprehensive examination and evaluation performed. — Differential diagnoses considered and reasons for eliminating or identifying specific conditions. — Diagnostic tests conducted, their results, and accompanying interpretations. — Any concurrent medications and their impact on the condition, if applicable. 4. Treatment Plan and Outcomes: — Outline of the treatment plan, including medications prescribed, dosage, and frequency. — Description of any surgical interventions, if warranted. — Response to treatment, including improvements, setbacks, or any adverse effects experienced. 5. Prognosis and Recommendations: — Expert opinion on the future course of the condition. — Specific recommendations for further investigations or consultations required, if any. — Any anticipated long-term effects, complications, or necessary lifestyle adjustments. Please ensure that the narrative medical report is addressed to me directly and includes your professional qualifications, clinic's contact details, and a signature confirming its authenticity. If there are any relevant medical records or test results that supplement the report, I would be grateful if you could include copies as well. Due to the time-sensitive nature of my requirements, I kindly request that you prioritize the completion of this narrative medical report within [reasonable timeframe]. If any fees apply for the preparation and provision of this report, please do let me know in advance. Thank you for your attention to this matter, and I appreciate your ongoing care and support. Should you have any questions or require further information, please do not hesitate to contact me. Yours sincerely, [Your Name] [Your Contact Information]