It is with mixed emotions that I am announcing my retirement from active practice, effective (date) . It has been a great pleasure providing for your health care needs over the years, and it is not easy for me to give it up.
As of (date) , Dr. Robert Smith will be taking over my practice. I am pleased that you have the opportunity to have him as your physician. Dr. Smith is a well-trained graduate of State University Medical School. He served his internship at Capital Memorial Hospital in Capital City and completed his residency at Jefferson University. I am glad to have left my patients in his capable hands. Of course, you may seek medical care from another doctor if you like. If you choose to do so, I recommend looking for a new physician as soon as possible. Ms. Carla Johnson at the Capital County Medical Society can help you begin your search by giving you the names of doctors in the area who are accepting new patients.
Your medical records are confidential, and a copy can be transferred to another doctor or released to you or another person you designate only through your permission. If you plan to continue with this office, you can sign an authorization form to release your files to Dr. Smith on your next visit. If you choose to see a different physician, please sign the enclosed authorization form and return it to my office as soon as possible so we may transfer your records to your new doctor. Until then, your records will remain on file at my former office.
I have greatly valued our relationship, and thank you for your loyalty and friendship over the years. Best wishes for your future health.
Jane X. Doe, MD
NOTICE: Please check the Texas Medical Board Web site ( www.tmb.state.tx.us ) for current updates on its rules and policies with respect to this issue.
This sample has been taken from TMA's Transitions, Legal Considerations in Closing or Selling a Medical Practice . This publication offers guidance from TMA's Office of General Counsel on the host of areas a physician must consider when making a practice change. It is available to TMA Members for $37.89 (includes tax). Order Transitions .
Practice Change Sample Forms