[Date]
[Your Name]
[Your Company Address]
[EYour Company Email]
Subject: Termination of Patient-Provider Relationship
Greeting:
Address the patient formally (e.g., "Dear Patient’s Name,")
Reason for the Letter:
Explain the purpose of the letter (e.g., to notify the patient of the termination of the provider-patient relationship due to legal issues)
Legal Grounds:
Briefly mention the specific legal issues that led to the termination (e.g., non-compliance with treatment, failure to meet legal requirements, violations of office policies)
Importance of Compliance:
Discuss the need for a mutually respectful and legal provider-patient relationship
Transfer of Medical Records:
Provide instructions on how the patient can request the transfer of their medical records to a new provider
Referral to Other Providers:
Suggest alternative healthcare professionals or facilities
Emergency Care:
Clarify that the patient will receive emergency care as required until they establish care with a new provider
Expression of Gratitude:
Thank the patient for their time and cooperation during the treatment period
Final Contact Information:
Offer to assist with record transfer and any other follow-up needs
Formal Sign-Off:
Sincerely,
[Your Name]
[Your Title/Position]
Medical Records Transfer Form (if applicable)
Templates
Templates