Massachusetts Sample Letter for Termination of Physician's Care - Patient to Physician

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US-0237LR
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This form is a sample letter in Word format covering the subject matter of the title of the form.

How to fill out Sample Letter For Termination Of Physician's Care - Patient To Physician?

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FAQ

How Can I End the Patient/Physician Relationship? You can end the patient/physician relationship by explicitly telling your doctor that you no longer want to be treated by him or her.

Removal from a doctor's practices requires a very specific protocol be followed. The colleges say the doctor must have a bona fide reason for termination, and must tell the patient clearly. Ideally, it's done in person. The doctor must also write a termination letter, which is handed to the patient during the visit.

In general, the physician-patient relationship can be terminated in two ways without creating liability for abandonment: 1) the physician ends the relationship after giving the patient notice, a reasonable opportunity to find substitute care and the information necessary to obtain the patient's medical records, or 2)

The physician terminates the physician-patient relationship by notifying the patient in writing of withdrawal from care after a specific time which is stated in the letter. The patient is also given information necessary to obtain their medical records or transfer to another provider.

In general, the physician-patient relationship can be terminated in two ways without creating liability for abandonment: 1) the physician ends the relationship after giving the patient notice, a reasonable opportunity to find substitute care and the information necessary to obtain the patient's medical records, or 2)

When you decide to end your relationship with a patient, inform him or her in writing and send the letter by certified mail, with a return receipt requested. If it's possible to describe the reason for the termination in a brief, clear, objective way, do so in the letter.

The physician terminates the physician-patient relationship by notifying the patient in writing of withdrawal from care after a specific time which is stated in the letter. The patient is also given information necessary to obtain their medical records or transfer to another provider.

How to Write a Patient Termination Letter Due to Non-ComplianceGet straight to the point. Don't beat around the bush.Provide the reason(s) for the discharge.Give the patient a clear, dated deadline to find a new provider.Mention emergency care.Offer to transfer medical records.

Physicians are reminded that patients may continue to de-roster themselves by contacting the Service Ontario INFOline at 1-800-267-8097.

This letter is to advise you that I will no longer be available to provide medical services to you after (FUTURE DATE ALLOWING PATIENT REASONABLE TIME TO FIND ANOTHER PHYSICIAN). I will be available to treat you until (DATE FROM ABOVE), so that you will have access to care while you choose another physician.

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Massachusetts Sample Letter for Termination of Physician's Care - Patient to Physician