Sample Follow-up Letter to Patient
| Date: 1/1/02 |
Last F/U Date: |
| |
Accession Number/Sequence Number |
| Jane Mary Doe |
|
| 123 Patient Street |
|
| Anytown, XX 99999 |
|
| |
|
Dear Jane Mary Doe,
The staff of Anytown Medical Center has a continuing interest
in its patients and would appreciate receiving the information
requested below concerning your condition since you were treated
here. We recommend that you have a physical examination annually
for more often if warranted by you or your physician.
What is the condition of your general health at the present
time?
_________________________________________________________________
Have you had any further medical or surgical treatment relating
to the cancer since leaving this hospital? If so, please describe
briefly:
_________________________________________________________________
_________________________________________________________________
Who is your physician now? _________________________________________
Physician's address: _______________________________________________
If your address given above is not correct, please provide
present address:
________________________________________________________________
Telephone number: _______________________________________________
If you are unable to complete this questionnaire, it would
be greatly appreciated if you could obtain the assistance
of a friend or relative and supply as much information as
possible.
Any further comments you may wish to make may be written
on the reverse side of this letter. A stamped, return-addressed
envelope is enclosed for your convenience. Thank you for taking
the time to respond to our patient information letter. We
at Anytown Medical Center are genuinely interested in your
health and look forward to hearing from you soon. Any questions
may be directed to the Cancer Registry at (999) 555-9999.
Sincerely yours,
John Doe, M.D.
Chair, Cancer Program
|
