Fillable Printable Sample New Patient Letter

Sample New Patient Letter

SAMPLE NEW PATIENT LETTER

Welcome to [PRACTICE NAME]. We are honored that you have chosen us as your

health care provider. Our goal is to provide the highest quality care for all of our patients

in a timely and respectful manner.

We will do our best to provide you with same-day office visits and accept walk-ins for

first available slots for all sick visits. You will need to bring your insurance card and a

photo ID with you for each appointment. Please let our staff know if you have had any

information changes since your last appointment. If you are unable to provide us with

your insurance card, your appointment will need to be rescheduled. You will be asked to

fill out new registration forms annually so we may update your information.

All co-pays and past due balances are expected at time of service, unless a prior

agreement has been made with our billing department.

We ask that you allow plenty of time to get to the office for your appointment. You may

be asked to reschedule your appointment if you are more than 15 minutes late. We will

strive to stay on time. From time to time, a patient emergency arises and we may be

running late for your visit. You will have the option to re-schedule or stay to be seen and

we will keep you informed of how long of a delay you may experience.

Please bring all of your prescription and over-the-counter medications with you at each

visit.

Our office policy for a missed appointment is:

 If it is an appointment for a new patient, the appointment will not be rescheduled;

 Two (2) no-show appointments will result in dismissal from the practice.

We understand that appointments sometime need to be changed, so we ask that you call

in advance if you cannot keep your scheduled appointment.

Providing the highest quality of professional care to our patients is very important to us.

Therefore, the following guidelines for dispensing medications in our office have been

established:

1. [PRACTICE NAME] does not offer chronic pain management and will not

dispense chronic pain medication (for example, chronic daily narcotics). We will

provide you with a referral to a pain management center if you need this

specialized form of care after evaluation by our physicians.

2. If you are on a medication that requires refills for a chronic disease (for example,

high blood pressure or diabetes), you will be given ample refills for 30 or 90 days

at a time during your office visit.

a. When you are down to a 30 day supply of medication, we ask that you

call and schedule your follow-up office visit in order to be evaluated and

have your medications adjusted or refilled. We ask that you allow enough

time for us to make an appointment so you’re not without your

medication.

3. For the safety and well-being of our patients,

a. Requests for new medications (including antibiotics) and medication

refills will not be taken over the phone or over the Internet during office

hours without an appointment and evaluation by the physician.

b. No new medications (including antibiotics) will be called in over the

phone after office hours by the on-call physician.

c. We understand that unexpected situations arise, thus a small refill of a

chronic medication will be granted for one or two days after office hours

on an as-needed basis determined by the on-call physician. This allows

patients to be seen and evaluated by the physician during office hours for

all their medication refills.

If you need to reach the physician after hours, you can reach our answering service at

[PHONE NUMBER]. Our office hours for patient care are [HOURS].

[PRACTICE NAME] is affiliated with [HEALTH CARE GROUP/HOSPITAL]. I am on

the medical staff at [HOSPITAL] and work with the many specialty physicians there. I

will be directing our patients to use [HOSPITAL]’s laboratory services and imaging

resources. Our electronic medical record allows us to receive patient results quickly and

efficiently through our direct link with [HOSPITAL] services. This is an important

resource in meeting our goal of providing high quality care in a timely manner.

Welcome to our practice and thank you for choosing [PRACTICE NAME] for all your

health care needs.

Sincerely,