Free Doctor’s Note for Therapy Appointment Template

Doctor’s Note for Therapy Appointment


October 3, 2080

Clinic Name: Wellness Clinic

Patient's Name: Jessica Smith
Address: 123 Wellness Way Springfield, IL 62701

To Whom It May Concern,

I am writing to formally confirm that Jessica Smith, born on March 12, 2052, has been under my care since August 15, 2060. After a thorough assessment, it has been determined that Jessica is experiencing a diagnosed anxiety disorder, which has significantly impacted her daily functioning and overall quality of life.

In light of her condition, I have recommended that she engage in regular therapy sessions to address her mental health needs and develop coping strategies. Jessica is currently scheduled for therapy appointments on Wednesdays at 3:00 PM and Fridays at 1:00 PM. These sessions are vital for her ongoing treatment, personal development, and emotional well-being.

I appreciate your understanding and support regarding her need to prioritize her mental health during this time. If you have any questions or require further information, please feel free to reach out to my office directly.

Thank you for your cooperation.

Warm regards,

Dr. [Your Name], PsyD
Licensed Clinical Psychologist
Illinois License Number: 984382

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