Hardship Letter Examples

   Doctor No Referral Hardship Letter

Dear {medical provider}:

Thank you very much for considering bringing me on as a patient. I know that your office requires a referral from a diagnosing doctor before you will take on a new patient. However, obtaining my diagnosis would create an extreme hardship because my former doctor {is no longer on my insurance/has died or left the practice/is unable to write a referral/etc.}.

Instead, I was able to access the doctor's notes via the online system and have enclosed them here. I hope this will be helpful.

In sum, on {date}, I began experiencing {symptom}. Ultimately, {Doctor Name} diagnosed me with {condition} and prescribed {medication/device}. I am not sure how to proceed with treatment and would greatly value your professional assessment.

My friends, including your patients {Name} and {Name}, speak very highly of your expertise and compassion.

I am due for {type of exam} and {procedure} after {date} of this year. I am {age}.

I am insured via {insurance provider}.

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Index of Hardship Letter Examples