Breaking up with your doctor takes courage and careful thought. Many patients stay with doctors they’re unhappy with because they don’t know how to end the relationship properly. This leads to poor healthcare experiences and unnecessary stress.
Writing a withdrawal letter helps both you and your healthcare provider close this chapter respectfully. A well-written letter explains your decision clearly while maintaining professionalism. Here are fifteen examples showing different approaches to handle this situation gracefully.
Letters of Withdrawal from Doctor’s Office
These sample letters demonstrate various ways to withdraw from a medical practice while keeping the tone appropriate and message clear.
1. Direct and Professional Withdrawal
*Dear Dr. Roberts,
Subject: Patient Withdrawal Notice
This letter serves as formal notice that your services as my primary care physician will no longer be needed. Beginning January 15, 2025, please remove me from your active patient roster.
During our three-year doctor-patient relationship, several concerns have arisen regarding appointment scheduling and communication. Despite bringing these issues to your staff’s attention multiple times, the problems continue. Last month’s incident where my test results weren’t shared for two weeks, causing a delay in starting treatment, was particularly concerning.
My new primary care physician will contact your office to request my medical records. Please transfer all my healthcare information, including test results, diagnoses, and treatment plans, to their practice. Their contact details are attached to this letter.
Thank you for the medical care you’ve provided since 2022. While this decision hasn’t been easy, it’s necessary for my ongoing healthcare needs. Please acknowledge receipt of this withdrawal notice and confirm the steps required to complete this transition.
Best regards,
Sarah Mitchell
Patient ID: 247813*
2. Relocation-Based Withdrawal
*Dear Dr. Chang and Staff,
Subject: Patient Withdrawal Request Due to Relocation
My family will be moving to Austin, Texas, next month due to a job transfer. As such, this letter formally notifies you that December 20, 2024, will be my last day as your patient.
Your exceptional care over the past seven years has meant so much to my family and me. From managing my chronic migraines to helping my children through various childhood illnesses, your dedication to patient care stands out. The way you always took time to answer questions and explain treatment options thoroughly made complex medical decisions easier to handle.
Please send my complete medical records to my new healthcare provider in Austin. Their office will contact you directly with the necessary authorization forms and contact information. Additionally, could you please provide a summary of my current medications and any pending referrals or tests?
Should any urgent matters regarding my healthcare arise before my departure, please contact me at (555) 123-4567 or via email at patient@email.com.
Thank you again for your outstanding medical care and support through the years.
Warmly,
Michael Torres
Patient ID: 385921*
3. Insurance Network Change Withdrawal
*Dear Dr. Thompson,
Subject: Patient Withdrawal Due to Insurance Network Changes
This letter notifies you that starting February 1, 2025, your services as my primary care physician will end due to recent changes in my employer’s health insurance coverage.
My new insurance plan places your practice outside the approved network of providers. The associated out-of-pocket costs make continuing care at your practice unfeasible for my family budget. This situation particularly disappoints me because your expertise in managing my arthritis has greatly improved my quality of life.
Please prepare my medical records for transfer to my new healthcare provider. Their office will send the required release forms shortly. A comprehensive list of my current medications and any scheduled follow-up appointments would also help ensure continuity of care.
Your approach to patient care sets a high standard. The way you incorporated both traditional and lifestyle-based treatments showed true dedication to finding the best solutions for each patient. The quarterly check-ins you suggested helped track my progress effectively and adjust treatments as needed.
Thank you for your understanding of this situation. This change stems solely from insurance requirements rather than any concerns about the quality of care received.
Best regards,
Patricia Reynolds
Patient ID: 473921*
4. Retirement-Based Withdrawal
*Dear Dr. Williams and Staff,
Subject: Patient Status Change – Doctor Retirement
Upon receiving notice of Dr. Williams’ upcoming retirement, this letter confirms my withdrawal from the practice effective March 31, 2025.
Though Dr. Stevens will take over the practice, this transition presents an opportunity to seek care closer to my home. The 45-minute drive to your office, which seemed reasonable when starting treatment five years ago, has become challenging with my current work schedule.
Your office has been exceptional in providing comprehensive healthcare services. Dr. Williams’ attention to detail and genuine concern for patient well-being created an environment where asking questions felt natural and welcomed. The staff’s efficiency in handling prescription refills and appointment scheduling made managing healthcare needs straightforward.
Please forward my complete medical history to my new provider. They will contact your office with the necessary transfer paperwork next week. Additionally, could you include a summary of recent lab work and any pending referrals?
Wishing Dr. Williams a wonderful retirement and thanking the entire staff for years of excellent care.
Sincerely,
David Cooper
Patient ID: 159753*
5. Quality of Care Concerns Withdrawal
*Dear Dr. Garcia,
Subject: Termination of Doctor-Patient Relationship
This letter serves as formal notice of my decision to end our doctor-patient relationship, effective immediately.
Recent experiences have led to this difficult decision. The repeated dismissal of my symptoms, which another physician later diagnosed as fibromyalgia, caused unnecessary suffering and delayed proper treatment. Additionally, the consistent hour-long wait times for scheduled appointments have disrupted my work commitments multiple times.
Please prepare my medical records for transfer. The authorization forms will arrive from my new healthcare provider within the week. A list of current prescriptions and any outstanding referrals would help ensure smooth continuation of care.
Your office may contact me at (555) 987-6543 regarding administrative matters related to this transition. However, for any medical concerns, please direct all communication through my new primary care physician.
While this decision may seem abrupt, it follows careful consideration of my healthcare needs and experiences over the past year.
Regards,
Jennifer Adams
Patient ID: 846275*
6. Personal Choice Withdrawal
*Dear Dr. Mitchell,
Subject: Patient Withdrawal Notice – Personal Decision
This letter notifies you of my decision to withdraw from your practice as of January 30, 2025.
After careful consideration, seeking a healthcare provider specializing in holistic medicine better aligns with my current health goals. While your medical expertise has been valuable, my growing interest in integrative medicine leads me to pursue a different treatment approach.
Your guidance through several health challenges over the past four years has been greatly appreciated. The thorough explanations you provided about treatment options always helped make informed decisions about my healthcare.
Please prepare my medical records for transfer to my new provider. They will submit the necessary release forms this week. A summary of my current health status and any recent test results would be helpful for the transition.
The professional care received from you and your staff deserves recognition. Your nurse practitioner’s follow-up calls after procedures showed genuine concern for patient recovery.
Thank you for understanding this personal choice.
Best wishes,
Amanda Foster
Patient ID: 753951*
7. Distance and Accessibility Withdrawal
*Dear Dr. Peterson,
Subject: Patient Withdrawal – Location Change
This letter formally notifies you of my withdrawal from your practice due to my recent move to the suburban area, effective December 1, 2024.
The new 90-minute commute to your office makes maintaining regular appointments impractical. This decision purely reflects logistical challenges rather than any dissatisfaction with the exceptional care received over the past six years.
Your expertise in managing my hypertension has been invaluable. The quarterly monitoring program you developed helped maintain stable blood pressure readings and reduced medication dependence through lifestyle modifications.
Please transfer my complete medical records to my new healthcare provider. Their office will send the required authorization forms shortly. A summary of my current treatment plan and any scheduled follow-up appointments would ensure continuity of care.
Your staff’s professionalism and efficiency in handling administrative matters deserves special mention. The reminder system for appointments and prescription refills helped maintain consistent treatment adherence.
Thank you for years of dedicated healthcare service.
Sincerely,
Thomas Wright
Patient ID: 264897*
8. Practice Merger Withdrawal
*Dear Dr. Johnson and Associates,
Subject: Patient Withdrawal Following Practice Merger
This letter serves as formal notification of my withdrawal from your practice following its merger with Riverdale Medical Group, effective March 15, 2025.
The merged practice’s new location adds significant travel time to each appointment. Additionally, the transition to a larger medical group may affect the personalized care approach that initially drew me to your practice.
Your dedicated care over the past three years has been remarkable. From managing my seasonal allergies to providing prompt care during acute illnesses, your medical guidance has consistently met my healthcare needs.
Please prepare my medical records for transfer to my new provider. They will submit the necessary release forms next week. A list of current prescriptions and any pending referrals would help ensure smooth continuation of care.
The small practice environment you maintained created comfortable doctor-patient interactions. Your staff’s personal attention and quick response to medical questions will be missed.
Thank you for understanding this transition decision.
Regards,
Maria Rodriguez
Patient ID: 951357*
9. Communication Style Withdrawal
*Dear Dr. Turner,
Subject: Notice of Patient Withdrawal
This letter formally ends our doctor-patient relationship, effective February 28, 2025.
Different communication preferences have led to this decision. The limited time allocated during appointments often leaves questions unanswered, creating uncertainty about treatment plans. Additionally, the difficulty in reaching your office for urgent matters has caused unnecessary stress.
Please prepare my complete medical records for transfer. My new healthcare provider will send the required authorization forms this week. A summary of recent treatments and any outstanding referrals would help maintain continuity of care.
Your medical expertise and diagnostic skills deserve acknowledgment. The accurate diagnosis of my thyroid condition demonstrated your clinical competence. However, the need for clearer communication about treatment options and medication side effects has become increasingly important for managing my health effectively.
Thank you for the medical care provided since 2023.
Sincerely,
Richard Barnes
Patient ID: 357159*
10. Health Management Approach Withdrawal
*Dear Dr. Harrison,
Subject: Patient Withdrawal – Healthcare Approach Change
This letter notifies you of my decision to withdraw from your practice, effective January 31, 2025.
My healthcare needs have evolved, requiring a more preventive approach to managing chronic conditions. While your treatment of acute issues has been excellent, seeking a provider focusing on long-term health management better suits my current healthcare goals.
Your prompt attention during medical emergencies has been greatly appreciated. The efficient handling of my recent bronchitis episode demonstrated your expertise in acute care situations.
Please transfer my medical records to my new healthcare provider. They will forward the necessary release forms shortly. A comprehensive list of current medications and any scheduled follow-ups would ensure smooth transition of care.
Your staff’s professionalism in handling administrative matters deserves recognition. The efficient prescription refill system particularly helped maintain medication consistency.
Thank you for understanding this healthcare decision.
Best regards,
Sandra Wilson
Patient ID: 852963*
11. Schedule Compatibility Withdrawal
*Dear Dr. Phillips,
Subject: Patient Withdrawal Notice – Schedule Conflicts
This letter serves as formal notice of my withdrawal from your practice, effective December 15, 2024.
My work schedule change to night shifts makes attending appointments during your office hours increasingly difficult. Despite the high quality of care received, the lack of early morning or evening appointment options necessitates finding a provider with more flexible scheduling.
Your thorough approach to healthcare has been valuable. The comprehensive annual physicals and detailed follow-up plans helped maintain optimal health over the past four years.
Please prepare my medical records for transfer to my new provider. They will submit the required authorization forms next week. A summary of recent lab work and any pending referrals would help ensure continuity of care.
The professional atmosphere maintained by your staff made every visit pleasant. The efficient check-in process and minimal wait times showed respect for patients’ schedules.
Thank you for your understanding of this situation.
Sincerely,
Kevin Marshall
Patient ID: 741852*
12. Family Care Consolidation Withdrawal
*Dear Dr. Lewis,
Subject: Family Patient Withdrawal Notice
This letter notifies you of our family’s withdrawal from your practice, effective March 1, 2025.
To streamline our healthcare management, we have decided to consolidate all family medical care with a single provider who can accommodate both adult and pediatric patients. This change will simplify scheduling and allow better coordination of our family’s healthcare needs.
Your care for my husband and me over the past five years has been excellent. The way you handled his diabetes management and my preventive care showed true medical expertise.
Please transfer our complete medical records to our new family practice. Their office will send the necessary release forms this week. A summary of current treatments and medications for both of us would help ensure seamless continuation of care.
Your staff’s friendly demeanor and efficiency in handling insurance matters made administrative tasks straightforward.
Thank you for years of quality healthcare service.
Best wishes,
Elizabeth and James Chen
Patient IDs: 369852, 369853*
13. Healthcare Philosophy Withdrawal
*Dear Dr. Brooks,
Subject: Patient Withdrawal – Treatment Philosophy
This letter serves as formal notification of my withdrawal from your practice, effective February 15, 2025.
After careful consideration, seeking a healthcare provider whose treatment philosophy better aligns with my preference for minimal medication intervention seems appropriate. While your traditional medical approach has merit, my growing interest in lifestyle-based treatments guides this decision.
Your professional care during the past three years has been appreciated. The successful treatment of my acid reflux showed your medical competence.
Please prepare my medical records for transfer to my new provider. They will forward the required release forms shortly. A list of current prescriptions and any pending referrals would help ensure smooth transition of care.
Your office staff’s courtesy and efficiency in handling administrative matters deserves recognition. The clear explanation of insurance benefits helped make informed decisions about treatments.
Thank you for understanding this personal healthcare choice.
Regards,
William Taylor
Patient ID: 147258*
14. Practice Policy Changes Withdrawal
*Dear Dr. Morgan,
Subject: Patient Withdrawal Due to Policy Changes
This letter formally notifies you of my withdrawal from your practice following recent changes in office policies, effective January 20, 2025.
The new requirement for payment of missed appointments, even with 24-hour notice, and the shortened appointment times make continuing care at your practice impractical for my situation. These changes significantly affect my ability to manage healthcare needs effectively.
Your medical expertise over the past four years has been valuable. The management of my asthma through various seasonal changes demonstrated your clinical skills.
Please transfer my complete medical records to my new healthcare provider. They will submit the necessary release forms next week. A summary of my current treatment plan and any scheduled follow-ups would ensure continuity of care.
The previous flexibility in scheduling and comprehensive appointment times created an environment conducive to thorough healthcare discussions.
Thank you for understanding this decision.
Sincerely,
Catherine Lee
Patient ID: 258963*
15. Medicare Coverage Change Withdrawal
*Dear Dr. Anderson,
Subject: Patient Withdrawal Notice – Medicare Plan Change
This letter serves as official notification that starting March 1, 2025, your services will no longer be needed as my primary care physician due to changes in my Medicare coverage plan.
My new insurance network doesn’t include your practice, which forces this difficult decision. Over the past decade, your medical guidance has been invaluable. The way you handled my diabetes diagnosis with patience and clear explanations helped me understand and manage this condition effectively.
Please prepare my complete medical records for transfer to my new provider. The necessary authorization forms will arrive from their office next week. Could you also include a detailed list of my current prescriptions and any scheduled follow-up appointments or referrals?
Your practice deserves recognition for maintaining such high standards of patient care. The front desk staff always greeted patients warmly, and your nursing team provided exceptional support during every visit.
Thank you for understanding this situation. This change stems purely from insurance requirements rather than any dissatisfaction with your care.
Sincerely,
Robert Martinez
Patient ID: 629384*
Wrapping Up
These withdrawal letters show there’s no single right way to end a doctor-patient relationship. Each situation calls for its own approach, but maintaining professionalism and clarity remains essential. Keep the tone respectful, state your decision clearly, and provide necessary details about medical records transfer. A good withdrawal letter closes the door gently while opening another for better healthcare ahead.