[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-275012-en":3,"detail-sidebar-cat-1-en-105":29,"doc-seo-275012-105":73},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":11,"category_id":12,"category_name":13,"doc_title":14,"doc_description":15,"doc_content":16,"file_id":17,"file_url":18,"file_type":19,"file_size":20,"view_count":21,"is_deleted":4,"is_public":11,"is_downloadable":11,"audit_status":11,"page_count":11,"language":22,"language_code":23,"site_id":24,"html_lang":23,"table_of_contents":25,"faqs":26,"seo_title":27,"seo_description":15,"update_tm":28,"read_time":4},275012,13056703019662,"Evangeline","https://ap-avatar.wpscdn.com/avatar/be000253a8e92610077?_k=1778726343310543188",1,18,"Letters","Patient Termination Letter - Sample","SAMPLE PATIENT TERMINATION LETTER provides a ready-to-copy notification for a physician to end the treatment relationship with a patient. It specifies that routine and emergency care will continue for 30 days from the letter date, encourages the patient to promptly consult a replacement physician, and offers to transmit medical records. The template includes certified-mail delivery instructions, filing requirements in the chart, and guidance on alternative delivery and appointment denial considerations.","SAMPLE PATIENT TERMINATION LETTER  \nUSE APPROPRIATE LETTERHEAD  \nDate:  \nPatient Address Certified Mail \\#   \n(Patient’s address)  \nDear   :  \nThis letter is to inform you that I will no longer be your treating physician and will stop providing medical care to you effective 30 days from the date of this letter. I will continue to provide routine and emergency medical care to you for 30 days while you seek another physician.  \nI suggest you consult the Oklahoma Medical [Board website:](Board website: www.okmedicalboard.org/)[ ](Board website: www.okmedicalboard.org/)[www.okmedicalboard.org/](Board website: www.okmedicalboard.org/)[ ](Board website: www.okmedicalboard.org/)as soon as possible so that you may find another physician who will assume responsibility foryour care.  \nI will be pleased to assist the physician of your choice by sending him or her a copy of your medical records.  \nSincerely,  \n(Physician Signature)  \nPhysician’s name   Department of    \n***************************************************************************************************  \nInstructions:  \n1. Retype the letter onto your specific letterhead;  \n2. A reason for the dismissal may be given but it is not necessary;  \n3. Include the Oklahoma Medical Board Website: [www.okmedicalboard.org](www.okmedicalboard.org) for assistance in finding another physician.  \n4. Send this letter to the patient by certified mail with return receipt requested and regular mail;  \n5. File copy of letter and delivery receipt in patient’s chart ;  \n6. If unable to reach the patient by mail, or in the alternative, the letter may be hand delivered at a scheduled appointment and documented in the medical record. It would not be  \nappropriate to email a sensitive termination. You should not deny an appointment made before the termination has been received by the patient unless the patient has been given specific instructions, i.e., make payment, give drug test, etc. prior to showing up for the appointment. If they show up and do not meet the instructions, you may deny the visit;  \n7. This letter may be modified, contact the Oklahoma Medical Board 405-962-1400 or your personal lawyer if you have specific questions.","cbCaicMSki4ZBWRF","https://ap.wps.com/l/cbCaicMSki4ZBWRF","pdf",16140,14,"English","en",105,"# Letter Template\n## Key Notice Details\n## Delivery and Documentation Instructions","[{\"question\":\"How long will medical care continue after sending this termination letter?\",\"answer\":\"Medical care continues for 30 days from the date of the letter. Routine and emergency care remain available during that period while the patient seeks another physician.\"},{\"question\":\"What should the patient do to ensure continuity of care?\",\"answer\":\"The patient should consult another physician as soon as possible to assume responsibility for care. The letter also references assistance from the Oklahoma Medical Board website.\"},{\"question\":\"How should the termination letter be delivered and documented?\",\"answer\":\"Send the letter by certified mail with return receipt requested and also via regular mail, then file a copy and delivery receipt in the patient’s chart. If mail delivery fails, hand delivery at a scheduled appointment may be used and documented in the medical record.\"}]","Patient Termination Letter - Sample | PDF",1789484526,{"code":4,"msg":5,"data":30},[31,37,42,46,51,56,61,64,69],{"id":32,"doc_module":11,"doc_module_name":33,"category_name":34,"show_sort_weight":35,"slug":36},11,"Template","Presentations",90,"presentations",{"id":38,"doc_module":11,"doc_module_name":33,"category_name":39,"show_sort_weight":40,"slug":41},12,"Resumes",80,"resumes",{"id":21,"doc_module":11,"doc_module_name":33,"category_name":43,"show_sort_weight":44,"slug":45},"Invoices",70,"invoices",{"id":47,"doc_module":11,"doc_module_name":33,"category_name":48,"show_sort_weight":49,"slug":50},15,"Posters",60,"posters",{"id":52,"doc_module":11,"doc_module_name":33,"category_name":53,"show_sort_weight":54,"slug":55},16,"Social Media",50,"social-media",{"id":57,"doc_module":11,"doc_module_name":33,"category_name":58,"show_sort_weight":59,"slug":60},17,"Forms",40,"forms",{"id":12,"doc_module":11,"doc_module_name":33,"category_name":13,"show_sort_weight":62,"slug":63},30,"letters",{"id":65,"doc_module":11,"doc_module_name":33,"category_name":66,"show_sort_weight":67,"slug":68},21,"Paper Templates",5,"papers-templates",{"id":70,"doc_module":11,"doc_module_name":33,"category_name":71,"show_sort_weight":4,"slug":72},158,"General","general-158",{"code":4,"msg":74,"data":75},"ok",{"site_id":24,"language":23,"slug":76,"title":14,"keywords":77,"description":15,"schema_data":78,"social_meta":134,"head_meta":136,"extra_data":138,"updated_unix":139},"patient-termination-letter-sample","",{"@graph":79,"@context":133},[80,96,116],{"@type":81,"itemListElement":82},"BreadcrumbList",[83,87,90,93],{"item":84,"name":85,"@type":86,"position":11},"https://docshare.wps.com","Home","ListItem",{"item":88,"name":33,"@type":86,"position":89},"https://docshare.wps.com/template/",2,{"item":91,"name":13,"@type":86,"position":92},"https://docshare.wps.com/template/letters/",3,{"item":94,"name":14,"@type":86,"position":95},"https://docshare.wps.com/template/patient-termination-letter-sample/275012/",4,{"url":94,"name":14,"@type":97,"image":98,"author":103,"headline":14,"publisher":105,"fileFormat":108,"inLanguage":23,"description":15,"dateModified":109,"datePublished":110,"encodingFormat":108,"isAccessibleForFree":111,"interactionStatistic":112},"DigitalDocument",{"url":99,"@type":100,"width":101,"height":102},"https://docshare.wps.com/thumbnails/patient-termination-letter-sample/275012.png","ImageObject",442,249,{"name":9,"@type":104},"Person",{"url":84,"name":106,"@type":107},"DocShare","Organization","application/pdf","2026-10-22","2026-09-15",true,{"@type":113,"interactionType":114,"userInteractionCount":21},"InteractionCounter",{"@type":115},"ViewAction",{"@type":117,"mainEntity":118},"FAQPage",[119,125,129],{"name":120,"@type":121,"acceptedAnswer":122},"How long will medical care continue after sending this termination letter?","Question",{"text":123,"@type":124},"Medical care continues for 30 days from the date of the letter. Routine and emergency care remain available during that period while the patient seeks another physician.","Answer",{"name":126,"@type":121,"acceptedAnswer":127},"What should the patient do to ensure continuity of care?",{"text":128,"@type":124},"The patient should consult another physician as soon as possible to assume responsibility for care. The letter also references assistance from the Oklahoma Medical Board website.",{"name":130,"@type":121,"acceptedAnswer":131},"How should the termination letter be delivered and documented?",{"text":132,"@type":124},"Send the letter by certified mail with return receipt requested and also via regular mail, then file a copy and delivery receipt in the patient’s chart. If mail delivery fails, hand delivery at a scheduled appointment may be used and documented in the medical record.","https://schema.org",{"og:url":94,"og:type":135,"og:title":14,"og:site_name":106,"og:description":15},"article",{"robots":137,"canonical":94},"index,follow",{"doc_id":7,"site_id":24},1790054166]