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

• Category: Letters - Nonlegal - Termination
• State: Multi-State
• County: Hennepin
• 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. Sample Letter for Termination of Physician's Care — Patient to Physician in Hennepin, Minnesota [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 well. I am writing to inform you that, after careful consideration and discussion with my primary care physician, I have made the decision to terminate our professional relationship as my physician at [Clinic/Hospital Name]. This decision was not made lightly, but after ongoing concerns and issues that have impeded my confidence in the care I am receiving. Unfortunately, over the past few months, I have experienced several instances where I felt that my needs and concerns were not being addressed adequately. Communication breakdowns, prolonged wait times, and inconsistent treatment plans have left me feeling frustrated and dissatisfied as a patient. As an active participant in my own healthcare, I believe it is crucial to have a trusting and dependable relationship with my physician. Furthermore, it has become evident that there is a lack of coordination among the healthcare team at [Clinic/Hospital Name], which resulted in confusion and inconsistencies in the management of my medical conditions. I firmly believe that effective teamwork and clear communication are essential in providing comprehensive healthcare. Under these circumstances, I have decided to seek alternative medical care. I understand the importance of continuity of care and would appreciate your cooperation in facilitating the transfer of my medical records to my new physician. Please ensure that all relevant documents, including medical history, diagnoses, test results, treatment plans, and prescription records, are provided to my new healthcare provider as soon as possible. I would also like to express my gratitude for the care you have provided thus far. Although our professional relationship did not meet my expectations in the end, I acknowledge the time and effort you have dedicated to my healthcare needs. Please consider this letter as my formal request to terminate our physician-patient relationship effectively immediately. I kindly request that you acknowledge this termination in writing and provide me with a copy of my medical records within the timeframe stipulated by state law. Thank you for your understanding and cooperation in this matter. I trust that you will handle my request with the utmost professionalism and ensure a smooth transition of care. Should you require any additional information or have any questions, please do not hesitate to contact me. Wishing you continued success in your medical practice. Sincerely, [Your Name]

Sample Letter for Termination of Physician's Care — Patient to Physician in Hennepin, Minnesota [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 well. I am writing to inform you that, after careful consideration and discussion with my primary care physician, I have made the decision to terminate our professional relationship as my physician at [Clinic/Hospital Name]. This decision was not made lightly, but after ongoing concerns and issues that have impeded my confidence in the care I am receiving. Unfortunately, over the past few months, I have experienced several instances where I felt that my needs and concerns were not being addressed adequately. Communication breakdowns, prolonged wait times, and inconsistent treatment plans have left me feeling frustrated and dissatisfied as a patient. As an active participant in my own healthcare, I believe it is crucial to have a trusting and dependable relationship with my physician. Furthermore, it has become evident that there is a lack of coordination among the healthcare team at [Clinic/Hospital Name], which resulted in confusion and inconsistencies in the management of my medical conditions. I firmly believe that effective teamwork and clear communication are essential in providing comprehensive healthcare. Under these circumstances, I have decided to seek alternative medical care. I understand the importance of continuity of care and would appreciate your cooperation in facilitating the transfer of my medical records to my new physician. Please ensure that all relevant documents, including medical history, diagnoses, test results, treatment plans, and prescription records, are provided to my new healthcare provider as soon as possible. I would also like to express my gratitude for the care you have provided thus far. Although our professional relationship did not meet my expectations in the end, I acknowledge the time and effort you have dedicated to my healthcare needs. Please consider this letter as my formal request to terminate our physician-patient relationship effectively immediately. I kindly request that you acknowledge this termination in writing and provide me with a copy of my medical records within the timeframe stipulated by state law. Thank you for your understanding and cooperation in this matter. I trust that you will handle my request with the utmost professionalism and ensure a smooth transition of care. Should you require any additional information or have any questions, please do not hesitate to contact me. Wishing you continued success in your medical practice. Sincerely, [Your Name]