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1. Date and Address Block: Current date and full contact information for both the healthcare provider and patient
2. Subject Line: Clear indication that this is a Notice of Termination of Medical Care
3. Opening Statement: Professional greeting and immediate statement of the purpose of the letter
4. Non-Compliance Documentation: Specific instances of non-compliance, including dates and nature of incidents
5. Termination Statement: Clear statement of the decision to terminate the doctor-patient relationship
6. Transition Period Details: Specification of the notice period (typically 30 days) during which emergency care will still be provided
7. Continuity of Care Information: Instructions for obtaining medical records and finding a new healthcare provider
8. Emergency Care Instructions: Information about accessing emergency care during the transition period
9. Closing Statement: Professional closing with clear contact information for medical records requests
10. Signature Block: Healthcare provider's signature, name, title, and medical registration number
1. Specific Medical Advice: Include when patient has ongoing medical conditions requiring immediate attention or specific care instructions
2. Previous Warnings: Reference to prior written or verbal warnings when applicable to establish pattern of non-compliance
3. Insurance Information: Include when specific insurance-related instructions or implications need to be communicated
4. Referral List: List of alternative healthcare providers in the area, included when required by local medical board guidelines
5. Legal Notice: Additional legal disclaimers or notices required in specific jurisdictions or circumstances
1. Documentation of Non-Compliance: Detailed log of non-compliance incidents, including dates, nature of incidents, and any witnesses or documentation
2. Medical Records Request Form: Standard form for requesting transfer of medical records to new healthcare provider
3. Local Healthcare Provider Directory: List of local healthcare providers accepting new patients, including contact information and specialties
4. Prescription Information: Details of current prescriptions and refill status, if applicable
Healthcare
Medical Services
Primary Care
Specialist Medical Care
Mental Health Services
Dental Services
Allied Health Services
Private Healthcare
Public Healthcare
Healthcare Administration
Legal
Medical Administration
Clinical Operations
Patient Services
Quality Assurance
Risk Management
Compliance
Medical Records
Front Office
Practice Management
General Practitioner
Medical Consultant
Practice Manager
Healthcare Administrator
Medical Director
Clinical Director
Legal Compliance Officer
Medical Records Officer
Patient Services Manager
Quality Assurance Manager
Risk Management Officer
Healthcare Legal Advisor
Medical Secretary
Practice Nurse
Clinical Operations Manager
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