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TERMINATION OF DOCTOR/PATIENT RELATIONSHIP (Sample Six Specialist)Date Dear Mr. / Mrs., Re: termination of Dentist/Patient Relationships letter is to inform you of my/our intent to terminate our dentist/patient
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How to fill out termination of doctorpatient relationship

01
Review the doctor-patient relationship contract or agreement, if applicable.
02
Notify the doctor in writing about your decision to terminate the relationship.
03
Provide a valid reason for the termination, if required.
04
Follow any specific procedures or protocols outlined in the contract or agreement.
05
Return any outstanding medical records or documents to the doctor or their office.
06
Pay any outstanding bills or fees, if applicable.
07
Confirm the termination in writing and keep a copy for your records.

Who needs termination of doctorpatient relationship?

01
Patients who are no longer satisfied with the medical treatment or services provided by their current doctor.
02
Patients who have found another doctor and wish to transfer their care.
03
Patients who have experienced a breach of trust or a breakdown in communication with their doctor.
04
Patients who have relocated and need to establish a new doctor-patient relationship in their new location.
05
Patients who have achieved their treatment goals and no longer require medical care from their current doctor.

What is TERMINATION OF DOCTOR/PATIENT RELATIONSHIP Form?

The TERMINATION OF DOCTOR/PATIENT RELATIONSHIP is a writable document required to be submitted to the relevant address to provide certain information. It has to be filled-out and signed, which is possible manually, or by using a certain solution e. g. PDFfiller. It helps to fill out any PDF or Word document right in the web, customize it according to your needs and put a legally-binding e-signature. Once after completion, the user can easily send the TERMINATION OF DOCTOR/PATIENT RELATIONSHIP to the relevant recipient, or multiple ones via email or fax. The editable template is printable as well because of PDFfiller feature and options offered for printing out adjustment. Both in electronic and in hard copy, your form will have got neat and professional look. You may also save it as the template to use later, there's no need to create a new blank form over and over. Just amend the ready document.

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Before starting to fill out TERMINATION OF DOCTOR/PATIENT RELATIONSHIP MS Word form, make sure that you have prepared all the necessary information. That's a mandatory part, since some typos can cause unwanted consequences from re-submission of the full and filling out with missing deadlines and even penalties. You ought to be pretty observative when working with digits. At first sight, this task seems to be uncomplicated. Yet, you might well make a mistake. Some use such lifehack as saving their records in a separate document or a record book and then attach this into sample documents. However, come up with all efforts and provide true and genuine information with your TERMINATION OF DOCTOR/PATIENT RELATIONSHIP form, and check it twice during the filling out the required fields. If it appears that some mistakes still persist, you can easily make corrections when you use PDFfiller editor and avoid blowing deadlines.

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Termination of doctor-patient relationship is the ending of the professional association between a doctor and a patient.
Either the doctor or the patient can initiate the termination of the doctor-patient relationship.
The termination of the doctor-patient relationship can be documented through a formal letter or form provided by the medical facility or practitioner.
The purpose of termination of doctor-patient relationship is to formally end the professional association in a respectful and ethical manner.
The termination document should include the reason for the termination, any follow-up care recommendations, and a statement of understanding by both parties.
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