This form is a sample letter in Word format covering the subject matter of the title of the form.
Dear [Physician's Name], I hope this letter finds you well. I am writing to inform you of my decision to terminate your care as my physician effective immediately. While it was not an easy decision to make, I believe it is in my best interest to seek medical treatment elsewhere. I want to express my gratitude for your services thus far. You have been my healthcare provider for [duration] and I appreciate the care and attention you have given me during this time. However, I have come to the realization that a change is necessary to address my evolving healthcare needs. There are several reasons behind my decision to seek a new physician. Firstly, I feel that our doctor-patient relationship has become somewhat strained in recent months. Communication has become increasingly difficult, and I have not felt heard or understood during our appointments. It is important for me to have a physician whom I can openly communicate with and who can provide the necessary support and guidance. Additionally, I have found that the treatment plan we have been following has not yielded the expected results. Despite our efforts, my health has not improved, and I believe it is time I explore other medical options that may be more effective for my specific condition. Furthermore, I have done extensive research and sought recommendations from trusted sources, including friends and family, who have suggested seeking a second opinion or considering alternative treatments. While I understand that medical opinions may differ, I believe it is crucial for me to explore these options to ensure I am receiving the most suitable and beneficial care for my condition. I plan to transfer my medical records to my new healthcare provider promptly. I kindly request that you arrange for the transfer of these documents to ensure a smooth transition and continuity of care. Should any fees be associated with the records transfer, please inform me so that I may provide payment accordingly. Please consider this letter as formal notice of termination of our physician-patient relationship. I appreciate your understanding in this matter and request that you acknowledge receipt of this letter. Thank you once again for your services, and I wish you all the best in your future endeavors. Sincerely, [Patient's Name] [Patient's Address] [City, State, ZIP] [Email Address] [Phone Number] (Note: This sample letter can be modified and customized according to individual situations and requirements. Different variations of this letter can address specific reasons for termination, such as seeking specialized care, relocating to a different area, or issues with insurance coverage. Additionally, variations of this letter can be prepared for different physician specialties, such as psychiatrists, surgeons, or general practitioners.)
Dear [Physician's Name], I hope this letter finds you well. I am writing to inform you of my decision to terminate your care as my physician effective immediately. While it was not an easy decision to make, I believe it is in my best interest to seek medical treatment elsewhere. I want to express my gratitude for your services thus far. You have been my healthcare provider for [duration] and I appreciate the care and attention you have given me during this time. However, I have come to the realization that a change is necessary to address my evolving healthcare needs. There are several reasons behind my decision to seek a new physician. Firstly, I feel that our doctor-patient relationship has become somewhat strained in recent months. Communication has become increasingly difficult, and I have not felt heard or understood during our appointments. It is important for me to have a physician whom I can openly communicate with and who can provide the necessary support and guidance. Additionally, I have found that the treatment plan we have been following has not yielded the expected results. Despite our efforts, my health has not improved, and I believe it is time I explore other medical options that may be more effective for my specific condition. Furthermore, I have done extensive research and sought recommendations from trusted sources, including friends and family, who have suggested seeking a second opinion or considering alternative treatments. While I understand that medical opinions may differ, I believe it is crucial for me to explore these options to ensure I am receiving the most suitable and beneficial care for my condition. I plan to transfer my medical records to my new healthcare provider promptly. I kindly request that you arrange for the transfer of these documents to ensure a smooth transition and continuity of care. Should any fees be associated with the records transfer, please inform me so that I may provide payment accordingly. Please consider this letter as formal notice of termination of our physician-patient relationship. I appreciate your understanding in this matter and request that you acknowledge receipt of this letter. Thank you once again for your services, and I wish you all the best in your future endeavors. Sincerely, [Patient's Name] [Patient's Address] [City, State, ZIP] [Email Address] [Phone Number] (Note: This sample letter can be modified and customized according to individual situations and requirements. Different variations of this letter can address specific reasons for termination, such as seeking specialized care, relocating to a different area, or issues with insurance coverage. Additionally, variations of this letter can be prepared for different physician specialties, such as psychiatrists, surgeons, or general practitioners.)