North Carolina Sample Letter to Doctor Requesting Narrative Medical Report

• Category: Letters - Legal - Personal Injury
• State: Multi-State
• Control #: US-0533LTR
• 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 Code] [Email Address] [Phone Number] [Date] [Doctor's Name] [Doctor's Address] [City, State, ZIP Code] Subject: Request for Narrative Medical Report Dear Dr. [Doctor's Last Name], I hope this letter finds you well. First and foremost, I would like to express my sincere gratitude for the medical attention and care you have provided to me throughout my treatment at your esteemed practice. Your expertise and dedication have been invaluable in ensuring my well-being. I am writing to kindly request your assistance in preparing a narrative medical report. The purpose of this report is to compile a comprehensive overview of my medical history, diagnoses, treatments, and prognosis. Understanding the importance of your time, I have prepared a detailed list of specific information that I would appreciate your inclusion in the report: 1. Current Medical Condition: Please provide a detailed description of my present medical condition, including symptoms, limitations, and the impact it has on my daily life. 2. Diagnosis: I kindly request a clear explanation of my diagnosed condition, detailing the medical tests, examinations, and observations that led to the diagnosis. Additionally, please include any differential diagnoses considered and the reasoning for ruling them out. 3. Treatment History: Please outline the various medical treatments, therapies, and medications prescribed to manage my condition. Include details such as dosage, frequency, duration, and any adverse reactions experienced. 4. Progress and Prognosis: I would greatly appreciate an assessment of how my condition has progressed since the initial diagnosis, including any changes or developments noted over time. Additionally, please provide your professional opinion on the expected long-term prognosis and potential future treatment options. 5. Functional Limitations: It would be immensely helpful if you could describe any limitations or restrictions imposed by my medical condition. This may include difficulty performing certain activities, mobility restrictions, or limitations on work-related tasks. 6. Recommendations: If applicable, please provide any recommendations or strategies for managing and improving my condition. This can involve lifestyle modifications, additional treatments, or referrals to other healthcare professionals or specialists. As this narrative medical report plays a vital role in my ongoing medical care, I kindly request that it be typed on official letterhead and signed by you. Your professional opinion and expertise will greatly assist me in seeking any necessary accommodations, disability benefits, or legal proceedings related to my condition. If there are any fees associated with preparing this report, please inform me in advance. I am more than willing to cover any reasonable expenses involved. Thank you for your prompt attention to this matter. I deeply appreciate the time and effort you dedicate to my healthcare needs. Should you require any additional information or clarification, please do not hesitate to contact me at [Your Phone Number] or [Your Email Address]. Wishing you good health and success in your practice. Sincerely, [Your Name]

[Your Name] [Your Address] [City, State, ZIP Code] [Email Address] [Phone Number] [Date] [Doctor's Name] [Doctor's Address] [City, State, ZIP Code] Subject: Request for Narrative Medical Report Dear Dr. [Doctor's Last Name], I hope this letter finds you well. First and foremost, I would like to express my sincere gratitude for the medical attention and care you have provided to me throughout my treatment at your esteemed practice. Your expertise and dedication have been invaluable in ensuring my well-being. I am writing to kindly request your assistance in preparing a narrative medical report. The purpose of this report is to compile a comprehensive overview of my medical history, diagnoses, treatments, and prognosis. Understanding the importance of your time, I have prepared a detailed list of specific information that I would appreciate your inclusion in the report: 1. Current Medical Condition: Please provide a detailed description of my present medical condition, including symptoms, limitations, and the impact it has on my daily life. 2. Diagnosis: I kindly request a clear explanation of my diagnosed condition, detailing the medical tests, examinations, and observations that led to the diagnosis. Additionally, please include any differential diagnoses considered and the reasoning for ruling them out. 3. Treatment History: Please outline the various medical treatments, therapies, and medications prescribed to manage my condition. Include details such as dosage, frequency, duration, and any adverse reactions experienced. 4. Progress and Prognosis: I would greatly appreciate an assessment of how my condition has progressed since the initial diagnosis, including any changes or developments noted over time. Additionally, please provide your professional opinion on the expected long-term prognosis and potential future treatment options. 5. Functional Limitations: It would be immensely helpful if you could describe any limitations or restrictions imposed by my medical condition. This may include difficulty performing certain activities, mobility restrictions, or limitations on work-related tasks. 6. Recommendations: If applicable, please provide any recommendations or strategies for managing and improving my condition. This can involve lifestyle modifications, additional treatments, or referrals to other healthcare professionals or specialists. As this narrative medical report plays a vital role in my ongoing medical care, I kindly request that it be typed on official letterhead and signed by you. Your professional opinion and expertise will greatly assist me in seeking any necessary accommodations, disability benefits, or legal proceedings related to my condition. If there are any fees associated with preparing this report, please inform me in advance. I am more than willing to cover any reasonable expenses involved. Thank you for your prompt attention to this matter. I deeply appreciate the time and effort you dedicate to my healthcare needs. Should you require any additional information or clarification, please do not hesitate to contact me at [Your Phone Number] or [Your Email Address]. Wishing you good health and success in your practice. Sincerely, [Your Name]