![]() ![]() Recognizing the significant struggle for a healthcare team to treat an IBC patient, I am writing to request permission to allow a patient to seek and have care coverage outside of the normal network. ![]() I am citing the Reuth et al National cancer database article to reflect the need of a specialty tri-mode clinic for this less common and highly fatal form of breast cancer. As a matter of fact, the first CME written for IBC was only offered this year for the first time in September of 2018. IBC was first written about in the 1800’s but due to the rare status of this disease (SEER reflects under 5,000 dx a year in the US) standard of care is not commonly taught in medical school or even included in breast cancer medical conferences. On average we interact with over 150 new IBC patients per year in the United States alone. We are a 501c3 that focuses on education and research funding for inflammatory breast cancer (IBC).ĭaily we have the privilege of interacting with IBC patients from all over the country. I am the founder of the IBC Network Foundation. You can Download and print or email it in a PDF to needed parties. We have listed it below so you can read it. Make haste and download it right away! You can also see more on Medical School Letters.If you have issues getting care out of network, and wish to send a copy of this letter to your insurance company, we hope it will start a conversation to help bridge a gap in care. The file is quite compatible with all portable devices where you can make your changes before you print it our or decide to send it digitally. Our Formal Medical Request Letter in DOC format has been designed for your convenience, so you can easily get this basic template on your editing software programs and add the details you would require to finish the letter. You can also add your identification number of the previous hospital if for accuracy.Ĩ+ Medical Request Letter Templates 1. The last step left is to provide your creative signature, along with the typed full name at the bottom of the letter to the left corner. Make sure you thank the doctor who treated you before and helped you with the progress along with the other staff. Leave a space and add your file number as well for specifications.Īfter providing the hospital details, you need to construct a body of the printable letter mentioning your medical history in the previous organization and the current situation relevant to past emergencies. Mention the hospital name, address of the hospital and the contact details. Once you inform them that you need your medical records to send them the details of the hospital or center you want them to be transferred. Next, you have to mention the reason you left the area or locality, it may be due to a job transfer or change of residence and so on. Mention how you know the medical center and what kind of medical history you have with them. If you have cordial relations with the person, you can just write “Sir/Madam” instead of the name.Īfter the salutation, now you need to add your details. Leave a line after the organization details and then write “Dear Mr/Mrs. ![]() ![]() Salutations are added to address the person whom you are writing this letter. If you wish, you may also add the address as well. (full name)” and in the corresponding lines, write the person’s title and name of the organization. Since it’s a formal letter, write “Mr/Mrs. The first section in a request sample letter to start with is the details of the receiver to whom you are sending the letter. 6 Steps to Write a Medical Request Letter Step 1: Receiver Details ![]()
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