New Hampshire Sample Letter for Enclosure of Medical Reports

• Category: Letters - Legal - Workers Compensation
• State: Multi-State
• Control #: US-0950LTR
• Format: Word; Rich Text

Description

This form is a sample letter in Word format covering the subject matter of the title of the form. Sample Letter for Enclosure of Medical Reports — New Hampshire Workers' Compensation Claim [Your Name] [Your Address] [City, State, ZIP] [Email Address] [Date] [Recipient's Name] [Recipient's Designation] [Company Name] [Company Address] [City, State, ZIP] Subject: Enclosure of Medical Reports — [Claimant's Name], Claim Number [Claim Number] Dear [Recipient's Name], I hope this letter finds you well. I am writing to enclose the necessary medical reports and documentation regarding the ongoing workers' compensation claim for [Claimant's Name] (Claim Number: [Claim Number]). Please find the enclosed documents as follows: 1. [Medical Report #1]: This comprehensive medical report has been prepared by Dr. [Doctor's Name], outlining a detailed evaluation of [Claimant's Name]'s medical condition following the workplace incident. The report includes diagnostics, examinations, treatment plans, and prognosis. 2. [Medical Report #2]: The supplementary medical report, conducted by Dr. [Doctor's Name], provides an additional medical assessment in light of [Claimant's Name]'s progress after the initial examination. It covers any changes, improvements, or complications since the previous report. 3. [Medical Test Results]: Enclosed are the results of various tests and analyses conducted for [Claimant's Name]. These test results include X-rays, MRI scans, blood tests, and any other relevant investigations highlighting the extent of the injuries sustained. 4. [Prescription Medications]: Attached are the prescribed medications as prescribed by Dr. [Doctor's Name]. This document lists the medications, dosages, frequency, and their intended purposes within the recovery process. 5. [Therapy Reports]: The enclosed therapy reports, completed by licensed therapists [Therapist's Name(s)], summarize the treatments, sessions attended, and any progress observed following the recommended therapy plan. 6. [Specialist Consultations]: Attached is a document summarizing any consultations or referrals with specialists related to [Claimant's Name]'s case, such as orthopedists, neurologists, and psychologists. These reports provide additional insights and expert opinions on the injuries sustained. Please note that the above-mentioned documents are in compliance with the requirements outlined by the New Hampshire Workers' Compensation Board. These reports and records represent the most recent and relevant medical information concerning [Claimant's Name]'s injuries sustained from the workplace incident. Should you require any further documentation or information, please do not hesitate to contact me at [Your Phone Number] or [Your Email Address]. I kindly request that you acknowledge the receipt of these enclosed medical reports by signing and returning the enclosed copy of this letter. Thank you for your prompt attention to this matter. We trust that these comprehensive medical records will assist in the proper evaluation of the workers' compensation claim for [Claimant's Name]. We look forward to a fair and just resolution. Sincerely, [Your Name] Enclosure: [Number of Enclosures] cc: [Claimant's Name]

Sample Letter for Enclosure of Medical Reports — New Hampshire Workers' Compensation Claim [Your Name] [Your Address] [City, State, ZIP] [Email Address] [Date] [Recipient's Name] [Recipient's Designation] [Company Name] [Company Address] [City, State, ZIP] Subject: Enclosure of Medical Reports — [Claimant's Name], Claim Number [Claim Number] Dear [Recipient's Name], I hope this letter finds you well. I am writing to enclose the necessary medical reports and documentation regarding the ongoing workers' compensation claim for [Claimant's Name] (Claim Number: [Claim Number]). Please find the enclosed documents as follows: 1. [Medical Report #1]: This comprehensive medical report has been prepared by Dr. [Doctor's Name], outlining a detailed evaluation of [Claimant's Name]'s medical condition following the workplace incident. The report includes diagnostics, examinations, treatment plans, and prognosis. 2. [Medical Report #2]: The supplementary medical report, conducted by Dr. [Doctor's Name], provides an additional medical assessment in light of [Claimant's Name]'s progress after the initial examination. It covers any changes, improvements, or complications since the previous report. 3. [Medical Test Results]: Enclosed are the results of various tests and analyses conducted for [Claimant's Name]. These test results include X-rays, MRI scans, blood tests, and any other relevant investigations highlighting the extent of the injuries sustained. 4. [Prescription Medications]: Attached are the prescribed medications as prescribed by Dr. [Doctor's Name]. This document lists the medications, dosages, frequency, and their intended purposes within the recovery process. 5. [Therapy Reports]: The enclosed therapy reports, completed by licensed therapists [Therapist's Name(s)], summarize the treatments, sessions attended, and any progress observed following the recommended therapy plan. 6. [Specialist Consultations]: Attached is a document summarizing any consultations or referrals with specialists related to [Claimant's Name]'s case, such as orthopedists, neurologists, and psychologists. These reports provide additional insights and expert opinions on the injuries sustained. Please note that the above-mentioned documents are in compliance with the requirements outlined by the New Hampshire Workers' Compensation Board. These reports and records represent the most recent and relevant medical information concerning [Claimant's Name]'s injuries sustained from the workplace incident. Should you require any further documentation or information, please do not hesitate to contact me at [Your Phone Number] or [Your Email Address]. I kindly request that you acknowledge the receipt of these enclosed medical reports by signing and returning the enclosed copy of this letter. Thank you for your prompt attention to this matter. We trust that these comprehensive medical records will assist in the proper evaluation of the workers' compensation claim for [Claimant's Name]. We look forward to a fair and just resolution. Sincerely, [Your Name] Enclosure: [Number of Enclosures] cc: [Claimant's Name]