Wisconsin Sample Letter for Termination of Physician's Care - Patient to Physician

• Category: Letters - Nonlegal - Termination
• State: Multi-State
• Control #: US-0237LR
• Format: Word; Rich Text

Description

This form is a sample letter in Word format covering the subject matter of the title of the form. Subject: Sample Letter for Termination of Physician's Care — Patient to Physician Dear [Physician's Name], I hope this letter finds you well. I am writing to inform you that after careful consideration, I have made the decision to terminate our physician-patient relationship effective [date]. I appreciate the medical care and support you have provided thus far; however, I believe it is in my best interest to seek alternative healthcare options. Furthermore, I would like to express my gratitude for the quality of care you have delivered during our time together. Your expertise, professionalism, and dedication have been instrumental in managing my health concerns. Your staff has always been courteous and helpful, making each visit a positive experience. However, I have recently encountered circumstances that have led me to reevaluate my healthcare needs and explore other options. While it was a difficult decision to make, I believe it is important to prioritize my wellbeing and ensure that I receive the most suitable medical attention. Considering the termination of our physician-patient relationship, I kindly request that you arrange for the transfer of my medical records to the healthcare provider I have chosen, as per my rights under the Health Insurance Portability and Accountability Act (HIPAA). Your cooperation in this matter would be greatly appreciated. Please inform me of any specific procedures or forms required to facilitate this transfer, and I will promptly provide the necessary information. I want to emphasize that this decision is not a reflection of your medical expertise or the quality of care you provide. Rather, it is an individual preference that I believe will contribute to my overall well-being. I am confident that you will continue to offer great care to your current patients and make a positive difference in their lives. Thank you again for the excellent care you and your team have provided me thus far. I genuinely value the time and effort you have dedicated to my healthcare needs. I wish you continued success in your medical practice. Please acknowledge receipt of this letter and provide any instructions or information required for the transfer of my medical records. If there are any outstanding payments or administrative tasks that need to be settled before ending our physician-patient relationship, kindly inform me so that I can address them accordingly. With appreciation and warm regards, [Your Name] [Your Address] [City, State, ZIP] [Phone Number] [Email Address] Keywords: Wisconsin, termination, physician's care, patient, sample letter, healthcare options, medical records, HIPAA, medical expertise, quality of care, well-being, gratitude, medical practice.

Subject: Sample Letter for Termination of Physician's Care — Patient to Physician Dear [Physician's Name], I hope this letter finds you well. I am writing to inform you that after careful consideration, I have made the decision to terminate our physician-patient relationship effective [date]. I appreciate the medical care and support you have provided thus far; however, I believe it is in my best interest to seek alternative healthcare options. Furthermore, I would like to express my gratitude for the quality of care you have delivered during our time together. Your expertise, professionalism, and dedication have been instrumental in managing my health concerns. Your staff has always been courteous and helpful, making each visit a positive experience. However, I have recently encountered circumstances that have led me to reevaluate my healthcare needs and explore other options. While it was a difficult decision to make, I believe it is important to prioritize my wellbeing and ensure that I receive the most suitable medical attention. Considering the termination of our physician-patient relationship, I kindly request that you arrange for the transfer of my medical records to the healthcare provider I have chosen, as per my rights under the Health Insurance Portability and Accountability Act (HIPAA). Your cooperation in this matter would be greatly appreciated. Please inform me of any specific procedures or forms required to facilitate this transfer, and I will promptly provide the necessary information. I want to emphasize that this decision is not a reflection of your medical expertise or the quality of care you provide. Rather, it is an individual preference that I believe will contribute to my overall well-being. I am confident that you will continue to offer great care to your current patients and make a positive difference in their lives. Thank you again for the excellent care you and your team have provided me thus far. I genuinely value the time and effort you have dedicated to my healthcare needs. I wish you continued success in your medical practice. Please acknowledge receipt of this letter and provide any instructions or information required for the transfer of my medical records. If there are any outstanding payments or administrative tasks that need to be settled before ending our physician-patient relationship, kindly inform me so that I can address them accordingly. With appreciation and warm regards, [Your Name] [Your Address] [City, State, ZIP] [Phone Number] [Email Address] Keywords: Wisconsin, termination, physician's care, patient, sample letter, healthcare options, medical records, HIPAA, medical expertise, quality of care, well-being, gratitude, medical practice.