Dear Mr./ Mrs. :
Main Street Eye Center will no longer be able to provide eye care services or products for you. We are terminating the optometrist / patient relationship because it has become clear that the trust and confidence required is no longer present and it would be in your best interest to obtain eye care from another provider.
Our doctors will be available for the next thirty days to provide treatment for you in the event of an eye emergency. Please let me know if you need assistance in finding another eye care provider. I will forward copies of your eye care records to the provider of your choice if you notify me in writing that I can release them.
Very truly yours,