To Whom It May Concern:
RE: (Patient’s name)
This patient has a bleeding disorder called ____________________ indicating a
deficiency (and/or malfunction) of factor ___________. S/he is well
known to me. If internal or external bleeding occurs, the patient responds well
to early self-infused transfusions of anti-hemophilic factor plasma-derived or
recombinant concentrates. _________________’s (patient’s name)
judgement as to when these products should be used and as to the quantity may
be relied upon.
Yours truly,
(Doctor’s signature
name, position)
Last Updated 2009
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