Free Abusive Patient Termination Letter Layout Template
Abusive Patient Termination Letter Layout
[Date]
To: [Patient’s Full Name]
[Patient’s Address]
[City, State, Zip Code]
Re: Termination of Care
Dear [Patient’s Name],
We are writing to inform you that, effective [Date], we will no longer be able to provide medical services to you. This decision has been made after careful consideration and is a result of your recent behavior that we consider to be abusive. As a medical practice, we are committed to maintaining a professional and respectful environment for both our staff and patients. Unfortunately, your conduct during recent interactions has made it impossible for us to continue our patient-provider relationship.
The specific incidents that led to this decision include [briefly outline specific behavior/instances of abusive conduct]. We take these matters seriously and must ensure the safety and well-being of our staff and other patients.
Please be advised that we are providing you with the following information to ensure a smooth transition to a new provider:
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Referral to Other Providers: You may contact [List any referrals or alternative providers] to arrange for continued medical care. We will be happy to forward your medical records to the new provider upon receiving a signed release form.
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Medical Records: You have the right to request a copy of your medical records. Please contact our office at [phone number or email] to make a request.
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Emergency Care: We will continue to provide emergency care in situations that require immediate medical attention until you have secured a new healthcare provider.
We regret that we must take this step, but it is necessary for the well-being of everyone involved. Should you have any questions or concerns, please do not hesitate to contact our office.
Sincerely,
[Your Name]
[Your Title]
