_________________________, 20___
							(Date of Letter)


______________________________
(Hospital/Care Provider)
______________________________
(Street Address)
______________________________
(City, State and Zip Code)

RE: 	Transfer of Records

Attn:  Office Administrator

Dear Office Administrator:

	From the _______ day of ______________________________, ______(year), until
the _______ day of ______________________, _____(year), your facility provided care
for______________________________ (name of individual).  Due to specific circumstances,
including ____________________________________________________________________________
__________________ (list reasons or circumstances), it will be necessary for the
aforementioned patient to be transferred to another facility for continued care.
Therefore, arrangements should be made for the immediate transfer of the above-mentioned
patient, along with an immediate transfer of all medical records to __________________
____________________(name of new facility).  Kindly provide transmittal copies of all
records to the undersigned when the transfer of records occurs.  Also, please advise
the undersigned of the transfer date of the aforementioned patient so that the
undersigned may make necessary arrangements, including the processing of any insurance
payments or other payments that remain outstanding.

	Should you have any questions or concerns relative to the foregoing, kindly contact
the undersigned.  Thank you for your kind attention.

							Very truly yours,


							______________________________
							(Signature)
							______________________________
							(Address)
							______________________________
							(City, State and Zip Code)
							______________________________
							(Phone Number)


LAWCHEK, LTD. LETTER PRO Samples, Copyright 2006
This is not a substitute for legal advice.  An attorney must be consulted.