Patient Termination Letter No Show

Patient Termination Letter No Show

Download this Patient Termination Letter No Show Design in Google Docs, Word, PDF, Apple Pages Format. Easily Editable, Printable, Downloadable.

As a professional, your time is valuable. Should a patient miss out on several, exclusively-assigned appointments, then you may have to terminate that patient. Do so using the free to download and easily customized Free Patient Termination Letter No Show template.

[Sender Complete Address]

[Date]

[Name of Patient]
[Complete Address]

Dear [Name of Patient],

This letter is to inform you that I will no longer be your attending physician as of [Date]. This is primarily due to your successive failure to keep several appointments reserved exclusively for you.

I suggest that you find another physician immediately to provide your medical needs. Any delay could jeopardize your health, so I advise you do it as soon as possible.

I will remain available to provide medical services to you, but only on an emergency basis, until you have arranged for another health care in another practice.

Enclosed is a medical records release authorization form for your convenience. I will forward a copy of your medical record upon receipt of your signed authorization.

Respectfully,

[Name and Signature]
[Contact Details]

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