Dental Patient Release Letter

A dental patient release letter is a letter written by a dentist or someone on his behalf to the patient, in which the dentist informs the patient that he is releasing the individual as his patient and would not be providing his services to the individual in the future. This letter is a formal notification and requires a valid reason for the release, as the dentist is not legally allowed to abandon a patient or stop serving him without having a strong justification.

A dentist can release a patient for various reasons, such as:

  • There is a bad patient-doctor relationship.
  • The dentist or facility lacks the required equipment or treatment.
  • The dentist is moving to a faraway place.
  • The dentist does not have enough slots available for a patient’s treatment.
  • The patient is no longer on the dentist’s panel.

When a dentist is writing a dental patient release letter, he may write it concisely or comprehensively. Depending on the required details and the patient’s case, the dentist decides what needs to be included in this letter. Generally, the following information is included:

  • Date.
  • Details of the patient.
  • Details of the dentist.
  • Inform about the release.
  • State the date from which the services would not be provided.
  • Reason for the release.
  • Show gratitude for choosing the dentist’s services.
  • Offer to provide the required documentation or referrals.
  • wishes for the future and treatment.
  • Signature and stamp.

The dental patient release letter may have to be used for legal purposes if required. Therefore, the dentist has to be careful and accurate while writing it. He needs to provide a valid reason for the release to make it justified. Else, he might have to face the consequences of stopping his services due to a baseless reason to the extent that his license may get canceled.

Sample Dental Patient Release Letter




Dear Mr. Jacob,

I thank you for selecting me as your dentist and dental care provider. I was glad to provide my services to you and to have a developed doctor-patient relationship. Honoring our relationship, I need to inform you that I will no longer be able to cater to you and provide the treatment from 15th December 2030.

Your dental situation can best be dealt with with high-tech technology, which is not available in my hospital. If I carry on with your treatment, the old technology would not only be painful but also may not appropriately do the job. As I have a good relationship with you, I care about you and want the best treatment for you, which I will not be able to provide you. Therefore, I am formerly releasing you as my patient.

If you want, I can provide some suggested names of dentists, who are using the type of equipment required for your treatment. Also, I can provide any document or dental history required for your further treatment.

I wish you all the best.


Dr. Steven John.

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