Family Medicine Care

 

816C  E. .Arrowood Rd.  Charlotte,  NC 28217

 704  552 8332/9     -    Fax 980 225 0265

 

 

 

 June 15, 2016

   

Apreciados pacientes:

Debo informarles que por razones personales he dejado la de practicar medicina. No podre darles más cuidado médico. Yo recomiendo que busquen otro médico que cubra sus necesidades de salud.  Si no conoce otro médico usted puede contactar la sociedad médica de Carolina del Norte o visitar la página web del Board de Medicina de Carolina del Norte en  www.ncmedboard en busca de otros recursos.

 

Todos los records de los pacientes han sido transferidos a First Care Medical Clinic. Los doctors en First Care Medical Clinic se agradaran atendiendo sus necesidades médicas y First Care Medical Clinic tiene seis localidades en North Carolina y una en Rockhill. Ademas provee transporte sin costo en un radio de 15 millas a la redonda de cada una de sus clínicas. Los números de la clínica con respuesta en Espanol son: 1(800) 227-3881, 1(704) 291-9267, 1(803) 909-4040. Sitio Web: www.FirstCareCanHelp.com

 

Si desea obtener copias de sus records, usted cuenta con opciones. Si prefiere First Care Medical Clinic puede transferir sus records al médico que usted designe.  Debido a que los records son confidenciales usted necesita proveer una autorización escrita para hacer sus records disponibles para otro médico. También puede enviarme una autorización y yo hare que sus records sean enviados al médico que usted autorice. Por esta razón, se incluye una forma de autorización. Por favor complete la forma y retórnela a mi antes del 15 de Agosto. Después de esta fecha no tendré acceso a sus records y los deberá pedir a First Care Medical Clinic.

 

Siento mucho no poder continuar como su médico. Mis mejores deseos en su futuro de salud y felicidad.

 

 

Sinceramente,

Mario Hernandez, MD Benedict Okwara, MD
Family Medicine Care First Care Medical Clinic

 

 


June 15, 2016

 

Dear Patient:

 

Please be advised that because of personal circumstances, I have discontinued the practice of medicine. I will no longer be able to provide you with medical care.

I recommend that you find another physician to take care of you and you may choose any physician that meets your needs. If you do not know another physician, you may contact the North Carolina Medical Society or visit the North Carolina Medical Board website at www.ncmedboard.org for resources.

 

All our patients’ records have been transferred to First Care Medical Clinic. The doctors at First Care Medical Clinic are happy to attend to your medical needs and First Care Medical Clinic has six locations in North Carolina and one in Rock Hill, South Carolina.

First Care Medical Clinic provides free transportation within a 15 miles radius of each clinic location. Clinic telephone numbers in English and Spanish are: 1(800) 227-3881, 1(704) 291-9267, 1(803) 909-4040. Web site: www.FirstCareCanHelp.com

 

If you wish to obtain copies of your medical records, you have a few options. If you like, First Care Medical Clinic can transfer you prior records to a physician you designate.

Since these records are confidential, you will need to provide your written authorization to make your records available to another physician. You may also send the authorization form to me and I will see that your records are sent to the physician you designate on the authorization form. For this reason, I am enclosing an authorization form for you to use. Please complete the form and return it to me by August 15 2016. After this date, I will no longer have access to your records and you will need to request them from First Care Medical Clinic.

 

I am sorry that I cannot continue as your physician. I extend to you my best wishes for your future health and happiness.

  

Sincerely,

Mario Hernandez, MD Benedict Okwara, MD
Family Medicine Care First Care Medical Clinic

 

 

   

  Donations for legal costs defense Dr. Hernandez

 

Family Medicine Care

816 E.Arrowood Road Suite C

Charlotte, NC 28217

Ph# (704)552-8332   Fax# (980)225-0265

 

REQUEST FOR RELEASE OF MEDICAL RECORDS

 

To:______________________________________________________________

                Physician’s Name

________________________________________________________________

          Address

________________________________________________________________

               City                                                                     State                                     Zip

 

 

I hereby request that my medical records be released to:

_______________Family Medicine Care - Mario Hernandez MD___________

                Physician’s Name (Print)

________________________________________________________________

          Address

________________________________________________________________

               City                                                                     State                                     Zip

 

 

 

 

______________________________________________________________

                Patient’s Name                                                                                  Birth Date

________________________________________________________________

          Address

________________________________________________________________

               City                                                                     State                                     Zip

 

 

 

 

***Please provide all notes, labs, and exams on this patient***

 

 

Patient’s Signature: _________________________ Date:__________________