Sample letter for surgery clearance
SAMPLE DISCHARGE LETTER
letter) while you have an opportunity to arrange for another. physician. Once you have found another physician and we receive. an appropriate authorization, I will forward a copy of your medical. records. I will also be happy to discuss your case with the physician. assuming your care. Enclosed, please find a copy of a medical
[DOC File]SAMPLE LETTER TO SEND TO PATIENTS/Diabetes
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Berkley Clinic. 2905 W. 12 Mile Road. Berkley, MI 48072. T: 248-541-0770. F: 248-541-6862 Compton Clinic. 14325 Middlebelt Road. Livonia, MI 48154. T: 734-427-9222
[DOC File]11 -- Sample doctor's letter -- RA other than LOA ...
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Title: 11 -- Sample doctor's letter -- RA other than LOA (00340323).DOC Author: Claudia Center Last modified by: Daniel Mahoney Created Date: 9/5/2013 6:46:00 AM
[DOC File]865 Return to Duty After Absence for Medical Reasons
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865.1 Certification Required: All Bargaining Unit Employees and Those Nonbargaining Unit Employees Returning From Non-FMLA Absences. Return-to-work clearance may be required for absences due to an illness, injury, outpatient medical procedure (surgical), or hospitalization when management has a reasonable belief, based upon reliable and objective information, that
[DOCX File]Transgender Care
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MTF CHEST SURGERY MEDICAL CLEARANCE LETTER SAMPLE. Date . RE:DOB: To Whom It May Concern: Patient name. is a patient in my care at Facility/office name.. She originally established care with us on Date. Patient name has a transfeminine gender identity which is well established and stable. She notes she first knew her gender identity differed from his birth assigned sex at age.
[DOCX File]Welsh Mountain - Welsh Mountain
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MEDICAL CLEARANCE FOR DENTAL TREATMENT. 5/16/16. Date: Attention: Patient Name: Date of Birth: Our mutual patient, as noted above, is scheduled for dental treatment at our office. Treatment may include: Cleaning (simple or deep) Root Canal Therapy. Radiographs (x-rays) Nitrous Oxide.
[DOCX File]Transgender Care
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FTM TOP SURGERY MEDICAL CLEARANCE LETTER SAMPLE. Date . RE:DOB: To Whom It May Concern: Patient name. is a patient in my care at Facility/office name.. He originally established care with us on Date. Patient name has a transmasculine gender identity which is well established and stable. He notes he first knew his gender identity differed from his birth assigned sex at age.
[DOC File]PATIENT ED TEMPLATE.2
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A letter from a primary care provider stating surgical clearance (No need for a Medicine Consult prior to surgery). or A letter from a primary care provider stating medical concerns that must be addressed prior to surgery (see list on following page).
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