Free Medical Doctor Letter Outline Template

Medical Doctor Letter Outline


[date]

[Recipient's Name]
[Recipient's Title/Position]
[Organization/Institution Name]

Dear [Recipient's Name/To Whom It May Concern],

  1. Introduction

    • State the purpose of the letter clearly. Examples:

      • "I am writing to provide a medical certification for [Patient's Full Name]."

      • "This letter serves as a referral for [Patient's Full Name] to [specialist/treatment]."

  2. Patient Information

    • Full Name: [Patient's Name]

    • Date of Birth: [MM/DD/YYYY]

    • Relevant Identification (e.g., Patient ID or Record Number): [Optional]

  3. Medical History/Condition

    • Provide a concise summary of the patient’s condition or reason for the letter:

      • Date of diagnosis or condition onset.

      • Key symptoms, findings, or results (e.g., lab reports, imaging, etc.).

  4. Treatment and Current Status

    • Outline the treatment plan provided or followed so far.

    • Current status of the patient:

      • Improving, stable, or requires further intervention.

  5. Purpose/Recommendation

    • Specify the intention of the letter:

      • For Work: "The patient is currently unable to work due to [reason] and is expected to recover by [date]."

      • For Referral: "The patient is being referred for [specialty/procedure] due to [reason]."

      • For Other Purposes: Clearly outline.

  6. Medical Opinion (if applicable)

    • Professional judgment regarding prognosis, fitness, or next steps.

  7. Closing Remarks

    • Summarize the key message and offer further assistance if needed:

      • "Please feel free to contact me for further information regarding [Patient's First Name]'s medical status."

Sincerely,

[Your Name]

[Your Email]

[Your Company Name]


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