This form is a sample letter in Word format covering the subject matter of the title of the form.
Subject: [Full Name] — Termination of Physician's Care [Your Name] [Your Address] [City, State, ZIP Code] [Email Address] [Phone Number] [Date] [Physician's Name] [Physician's Address] [City, State, ZIP Code] Dear Dr. [Physician's Last Name], I hope this letter finds you in good health and high spirits. I am writing to inform you of my decision to terminate our physician-patient relationship effective immediately. Despite the concerns I have had regarding the level of care provided, it was not an easy decision to make, as I do value the professional services you have rendered thus far. Unfortunately, following thorough reflection and consultation with another medical professional, I have decided to explore alternative healthcare options that best align with my needs and medical goals. I firmly believe this decision will be in my best interest in terms of achieving optimal well-being. During our time together, I have appreciated your attention and dedication to my medical concerns. However, there have been certain aspects of our interaction which have led me to reevaluate whether we are an ideal match for the ongoing partnership between physician and patient. While I understand that there are variations and nuances in every physician's approach, the following reasons cement my resolve to seek another healthcare provider: 1. Lack of Timeliness: I have experienced an unreasonable delay in receiving test results, which has caused unnecessary stress and concern. Prompt and clear communication regarding diagnostic findings is crucial for comprehensive patient care. 2. Unaddressed Concerns: On multiple occasions, my concerns have been neglected or not given due attention, leading to feelings of being unheard and disregarded. It is crucial for my healthcare team to acknowledge my questions and anxieties, providing the necessary reassurance and information. 3. Inadequate Explanation: Medical jargon and complex terminology can sometimes be challenging to comprehend. I have felt frustrated by the lack of clear and concise explanations regarding my condition, treatment options, and potential side effects. 4. Limited Treatment Options: Despite efforts to discuss alternative treatment plans or explore potential complementary therapies, I have felt a resistance to discussing such options, leading to a sense of limited choices regarding my healthcare decisions. 5. Suboptimal Follow-up: There were instances where I felt a lack of proper follow-ups, making me question the thoroughness of our physician-patient relationship. Consistent and timely follow-up is necessary to ensure continuity of care and address any potential complications. Considering the listed concerns, I believe it is in my best interest to seek another healthcare provider who can provide a more tailored approach to my individual needs and preferences. I kindly request assistance in the transfer of my medical records to the new healthcare provider's office as soon as possible to ensure a seamless transition. I appreciate the care you have provided thus far and the time and energy you have dedicated to my medical well-being. Please consider this decision as a proactive step toward finding a collaborative healthcare partnership that better meets my specific requirements. Thank you for your understanding and cooperation in this matter. Should you require any further details or information, please do not hesitate to contact me at your convenience. Wishing you continued success in your medical practice. Sincerely, [Your Full Name]
Subject: [Full Name] — Termination of Physician's Care [Your Name] [Your Address] [City, State, ZIP Code] [Email Address] [Phone Number] [Date] [Physician's Name] [Physician's Address] [City, State, ZIP Code] Dear Dr. [Physician's Last Name], I hope this letter finds you in good health and high spirits. I am writing to inform you of my decision to terminate our physician-patient relationship effective immediately. Despite the concerns I have had regarding the level of care provided, it was not an easy decision to make, as I do value the professional services you have rendered thus far. Unfortunately, following thorough reflection and consultation with another medical professional, I have decided to explore alternative healthcare options that best align with my needs and medical goals. I firmly believe this decision will be in my best interest in terms of achieving optimal well-being. During our time together, I have appreciated your attention and dedication to my medical concerns. However, there have been certain aspects of our interaction which have led me to reevaluate whether we are an ideal match for the ongoing partnership between physician and patient. While I understand that there are variations and nuances in every physician's approach, the following reasons cement my resolve to seek another healthcare provider: 1. Lack of Timeliness: I have experienced an unreasonable delay in receiving test results, which has caused unnecessary stress and concern. Prompt and clear communication regarding diagnostic findings is crucial for comprehensive patient care. 2. Unaddressed Concerns: On multiple occasions, my concerns have been neglected or not given due attention, leading to feelings of being unheard and disregarded. It is crucial for my healthcare team to acknowledge my questions and anxieties, providing the necessary reassurance and information. 3. Inadequate Explanation: Medical jargon and complex terminology can sometimes be challenging to comprehend. I have felt frustrated by the lack of clear and concise explanations regarding my condition, treatment options, and potential side effects. 4. Limited Treatment Options: Despite efforts to discuss alternative treatment plans or explore potential complementary therapies, I have felt a resistance to discussing such options, leading to a sense of limited choices regarding my healthcare decisions. 5. Suboptimal Follow-up: There were instances where I felt a lack of proper follow-ups, making me question the thoroughness of our physician-patient relationship. Consistent and timely follow-up is necessary to ensure continuity of care and address any potential complications. Considering the listed concerns, I believe it is in my best interest to seek another healthcare provider who can provide a more tailored approach to my individual needs and preferences. I kindly request assistance in the transfer of my medical records to the new healthcare provider's office as soon as possible to ensure a seamless transition. I appreciate the care you have provided thus far and the time and energy you have dedicated to my medical well-being. Please consider this decision as a proactive step toward finding a collaborative healthcare partnership that better meets my specific requirements. Thank you for your understanding and cooperation in this matter. Should you require any further details or information, please do not hesitate to contact me at your convenience. Wishing you continued success in your medical practice. Sincerely, [Your Full Name]