Free Medical Waiver Letter Template
Medical Waiver Letter
August 16, 2055
Dr. Johan Green
Director of Health Services
Iowa Community Center
Des Moines, IA 50301
Dear Dr. Green,
I am requesting a medical waiver for the Iowa Marathon on September 30, 2055. I have a medical condition that prevents me from completing the standard 10-mile run. I have been diagnosed with chronic osteoarthritis, which limits my ability to participate in high-impact activities. Attached are documents from my physician, Dr. Alfonso Jewel, detailing my condition.
Requested Waiver Details:
|
Requirement |
Original Requirement |
Requested Accommodation |
|---|---|---|
|
Physical Activity |
10-mile run |
Modified fitness challenge |
Please find the attached documents:
-
Medical report from Dr. Alfonso Jewel
-
Verification of osteoarthritis diagnosis
-
Physical therapy plan
Feel free to contact me at 222 555 7777 or [Your Email] if you need more information. Thank you for your consideration.
Sincerely,
[Your Name]
