HTML Preview Medical Patient Termination Letter page number 1.
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Sample Patient Termination Letter
[Note: Before terminating the relationship, health care providers should consider any
facts and relevant laws that may impact the provider’s obligation to provide continued
care, including the Emergency Treatment and Active Labor Act (EMTALA), relevant
anti-discrimination statutes, and any contractual requirements]
Dear ,
Due to recent events, I will no longer be able to continue providing your medical
care; accordingly, it will be necessary for you to transfer your care to another health
care provider. I will continue to provide you with any necessary care until [STATE
DATE, USUALLY 30 DAYS OUT], which should give you sufficient time to transfer your
care; however, after that date, you will need to obtain medical care elsewhere.
Your condition [MAY/DOES] require continued care. I strongly encourage you to
immediately take action to transfer your care to an appropriate health care provider. If
you need assistance, [IDENTIFY LOCAL PHYSICIAN REFERRAL SERVICE, IF
AVAILABLE] may be able to help you find another appropriate provider. Alternatively,
your insurance program, local hospitals, or acquaintances may be able to refer you to
an appropriate provider.
We will make your medical records available to your new physician upon his or
her request. Please have your physician contact our office to make arrangements to
transfer the records.
Thank you.