Free Psychiatrist Patient Termination Letter Template
Psychiatrist Patient Termination Letter
Date: March 5, 2088
To: Ms. Clara Evergreen
123 Horizon Lane
New Haven, CT 06510
Subject: Termination of Psychiatric Services
Dear Ms. Evergreen,
I hope this letter finds you well. I am writing to formally inform you of my decision to discontinue our psychiatrist-patient relationship effective April 4, 2088. This decision was made after careful consideration of your treatment needs and the circumstances surrounding our sessions.
The primary reason for this decision is repeated missed appointments, which have disrupted the continuity of your care. As your mental health is of utmost importance, I strongly encourage you to seek ongoing care with another qualified mental health professional.
To assist with this transition, I have provided a list of resources below:
-
Lighthouse Mental Health Services – Call 1-800-765-4321 or visit www.lighthousementalhealth2088.com
-
Aurora Wellness Network – Contact them at 1-888-123-9876 or www.aurorawellness2088.org
I am available to provide care and emergency support until April 4, 2088, after which my services will no longer be available. If you would like me to share your medical records with your new provider, please complete and sign the attached Authorization to Release Medical Records form and return it to my office.
Should you have any questions or require further clarification, please feel free to contact me at [Your Email] or call (860) 555-2047.
I wish you the best in your continued mental health journey.
Sincerely,
Dr. [Your Name]
Psychiatrist
Solstice Psychiatry and Wellness Center
