NEDA TOOLKIT for Parents
SAMPLE LETTER #6
Letter from doctor describing any medical complications your child has had, the doctor’s recommendations for
treatment, and the doctor’s prediction of outcome if this treatment is not received. This is a sample physician
letter that parents can bring to their child’s doctor as a template to work from.
DATE To: [Get the name of a medical director at the insurance company]:
INS. CO. NAME & ADDRESS
Re: PATIENT’S NAME
DOB (Date of Birth)
Insurance ID#
We are writing this letter to summarize our treatment recommendations for [patient name]. We have been
following [patient name] in our program since [DATE]. During these past [NUMBER years], [patient name] has had
[NUMBER] hospitalizations for medical complications of [insert conditions, e.g., malnutrition, profound
bradycardia, hypothermia, orthostasis]. Each of the patient’s hospital admissions are listed below [list each and
every one separately]:
Admission Date – Discharge Date [condition]
In all, [patient] has spent [NUMBER] days of the past [NUMBER years] in the hospital due to complications of
[his/her] malnutrition.[Patient name’s] malnutrition is damaging more than [his/her] heart. [His/Her] course has
been complicated by the following medical issues:
List each issue and its medical consequence [e.g., secondary amenorrhea since DATE, which has the potential
to cause irreversible bone damage leading to osteoporosis in his/her early adult life.]
Despite receiving intensive outpatient medical, nutritional and psychiatric treatment, [patient name’s] medical
condition has continued to deteriorate with [describe symptoms/signs, e.g., consistent weight loss since DATE] and
is currently 83% of [his/her] estimated minimal ideal body weight (the weight where the nutritionist estimates[
he/she] will regain regular menses). White blood cell count and serum protein and albumin levels have been
steadily decreasing as well, because of extraordinarily poor nutritional intake.
Given this history, prior levels of outpatient care that have failed, and [his/her] current grave medical condition,
we recommend that [patient name] urgently receive more intensive psychiatric and nutritional treatment that can
be delivered only in a residential treatment program specializing in eating disorders. We recommend a minimum
60- to 90-day stay in a tiered program that offers: intensive residential and transitional components focusing on
adolescents and young adults with eating disorders (not older patients). [Patient] requires intensive daily
psychiatric, psychologic, and nutritional treatment by therapists well trained in the treatment of this disease. Such
a tiered program could provide the intensive residential treatment that [he/she] so desperately needs so [he/she]
can show that [he/she] can maintain any progress in a transitional setting. We do not recommend treatment in a
non-eating disorder-specific behavioral treatment center. [Patient]’s severe anorexia requires subspecialty-level
care. Examples of such programs would include [name facilities].
Anorexia nervosa is a deadly disease with a 10% to 15% mortality rate; 15% to 25% of patients develop a severe
lifelong course. We believe that without intensive treatment in a residential program, [patient name’s and
condition], and the medical complications that it causes, will continue to worsen causing [him/her] to be at
significant risk of developing lifelong anorexia nervosa or dying of the disease. We understand that in the past,
your case reviewers have denied [patient] this level of care. This is the only appropriate and medically responsible
care plan that we can recommend. We truly believe that to offer a lesser level of care is medically negligent. We
trust that you will share our grave concern for [patient’s] medical needs and approve the recommended level of
care to assist in [his/her] recovery.
Thank you for your thorough consideration of this matter. Please feel free to contact us with any concerns
regarding [patient’s] care.
Sincerely, [PHYSICIAN NAME]
Cc: [YOU]
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