Free Patient Termination Letter Template
Patient Termination Letter
Date: January 15, 2091
Company: [Your Company Name]
Address: 123 Healthcare Drive
Wellness City, HC 98765
Email: [Your Email]
To: Alaric Thorne
456 Patient Lane
Healing Town, HC 54321
Subject: Termination of Patient-Provider Relationship
Dear Alaric Thorne,
I hope this letter finds you well. After careful consideration, I regret to inform you that effective February 15, 2091, [Your Company Name] can no longer provide medical care for you. This decision was not made lightly and is based on the following reason(s):
This decision has been made due to repeated missed appointments and a continued lack of adherence to the prescribed treatment plans, despite our efforts to address these matters through reminders, consultations, and personalized guidance. These challenges have impacted our ability to provide you with the consistent and effective care you deserve.
Our priority is to ensure a smooth transition of care. I have included a list of other healthcare providers and clinics in the area to assist you during this time. You may also contact your insurance company for a comprehensive list of in-network providers.
We will remain available for urgent care needs until the effective termination date. Additionally, we will provide copies of your medical records upon your written request. Please contact our office at [Your Email] or call (123) 456-7890 for assistance.
Thank you for allowing us to be part of your healthcare journey. We wish you the best in finding a provider who meets your needs.
Sincerely,
[Your Name]
Medical Director
