Sample Patient Handouts and Letters
Patient education is an important aspect of primary care. Improve your communication of professional advice and practice policies using these sample handouts and letters.
You must be a PCC client to access those samples marked with an asterisk (*).
- Patient welcome letter formatted for use with PCC's Partner software MS Word PDF OpenOffice
- Questions patients should present to their insurance company prior to well visit MS Word PDF OpenOffice
- Letter to patients notifying them of your practice terminating contract with an insurance company MS Word PDF OpenOffice
- Letter to employers notifying them of your intention to terminate a contract with an insurance company MS Word PDF OpenOffice
- Letters notifying patients and employers of your intention to terminate a contract with an insurance company, part of PCC's article: 7 Steps Toward Successful Insurance Negotiation
- * Demographic and insurance information form Courtesy of Ellicott City Pediatric Associates
Patient Questionnaires
- * New patient questionnaire Courtesy of Ellicott City Pediatric Associates
- * Health history review questionnaire Courtesy of Ellicott City Pediatric Associates
- * Child symptom questionnaire Courtesy of Ellicott City Pediatric Associates
- *Parent/patient activity questionnaire to determine readiness for camp or other activity participation, courtesy of Ellicott City Pediatric Associates
- *Parent/patient sports questionnaire to determine readiness for sports participation, courtesy of Ellicott City Pediatric Associates
- * Safety survey for children 5 to 6 months old Courtesy of Ellicott City Pediatric Associates)
- * Safety survey for children 15 to 20 months old Courtesy of Ellicott City Pediatric Associates
- * Safety survey for children 1 to 4 years old Courtesy of Ellicott City Pediatric Associates
- * Safety survey for children 5 to 9 years old Courtesy of Ellicott City Pediatric Associates
- * Safety survey for children 10 to 14 years old Courtesy of Ellicott City Pediatric Associates
