Patient Termination Letter

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Updated November 04, 2024

A patient termination letter is used by physicians and other healthcare providers to notify patients that their relationship will end after a specified date. Because most states have their own requirements on how a provider must end a patient relationship, it is important to comply with state-specific laws to avoid charges of malpractice or patient abandonment.

The letter should include the following details:

Date of termination
Reason for termination
Referrals for continued care
Intent to transfer patient records to new provider

Sample Patient Termination Letter

Dr. Joni Mitchell Family Office
1234 Main St.
Los Angeles, CA 90002
(213) 123-4567
info@drjoni.comAugust 23, 2022Bob Milton
333 South St.
Los Angeles, CA 90212Dear Bob,

This letter is to formally notify you that as of October 1, 2022, I will no longer be able to continue providing your medical treatment. As we discussed previously, this termination is due to your non-payment for services provided to you over the last three months. Please see the attached document for a detailed breakdown of your overdue balance.

Over the next 30 days, I will still be available to provide you with any necessary care. Please use this time to find another physician to provide you with continued treatment after October 1. Your condition requires consistent care and supervision from a medical professional, so it’s very important that there is no interruption in receiving the care that you need. I have attached a list of similar physicians in the area and additional resources for finding low-cost medical care.

I will be happy to transfer your medical records to your new provider upon their request. They can contact our office via phone or email to make necessary arrangements.

Sincerely,

Dr. Joni Mitchell