WFH NETWORK

Sample Travel Letter from Treating Doctor

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)

 

Updated May 2012