Clinical Hardship Letter

There are bad times in every person’s life. Whenever there is a situation that you are unable to pay a certain amount at a health centre or a clinic, you can write a Clinical Hardship Letter to extend the deadline for a payment later.

In the first paragraph, mention the date the amount was due on. Also mention when you were treated at the health centre and what was the cause of your illness. In the second paragraph, add the reason as to why you are unable to pay the required expenses and request for an extension of the date given by the clinic.

Instructions

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    Sample Clinical Hardship Letter





    William Herald
    Manager Accounts
    Michigan Health Centre
    March 18, 2012

    To Whom It May Concern

    I am writing this letter in reference to the amount that I was due to pay this month. It is stated that I was treated for a severe cardiac problem at your clinic in January earlier this year and I am pleased to tell you that I have recovered well from the illness.

    Currently, I am going through a hard time as I lost my job due to the illness and am looking for a new one. You had advised me a 1 month bed rest which my previous company did not find suitable and I had to quit. I have already given a couple of interviews and am hopeful to be employed in the next few days.

    I request for an extension of time for clearing my medical expenses at your health centre. I am not in a financially stable condition right now and I will certainly pay the due amount once I land a new job. I am hopeful that you will understand my situation and will allow me to clear the dues next month.

    I am looking forward to a positive reply.

    Yours sincerely,
    Steve Downing

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    Template of Clinical Hardship Letter


    [Doctor’s Name]
    [Title]
    [Health Centre Name]
    [Date]

    To Whom It May Concern

    This letter is in reference to my outstanding medical expenses at ................. It is stated that I was treated for ...................... at your health centre in ................... By the grace of God, I have fully recovered from my illness and am feeling very well now.

    I wanted to request for an extension of the due date for the payment of the bills. I will certainly pay the due amount but require some time as my financial condition is not good at the moment. I am hopeful that you will be able to understand my situation.

    Yours sincerely,
    [Your Name]

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