Congratulations on your pending retirement. It has been a pleasure to have you as our child's pediatrician.
Enclosed please find the form needed to release a copy of my child's medical records. {Name} has been your patient since {date}.
Please include copies of all immunization records, along with any documentation including but not limited to: physical exams, surgery reports, x-ray reports, and lab orders and results.
We've been unable to secure a new provider for our child. The doctor to whom you referred us, Dr. {Other Provider}, is not accepting new patients, and our family physician doesn't accept minors.
Feel free to contact me if you need any additional information. Thanks again and take care.
Sincerely,
{Name}Download this cover letter — free!
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