13+ Sample Letter Of Medical Necessity Bariatric Surgery Pictures. To whom it may concern: I am respectfully requesting consideration for bariatric surgery.
I believe the patient is a good candidate for surgery and would benefit from significant weight loss.
Browse our example of medical necessity letter template. However, the sample letters of medical necessity are not intended to provide specific guidance on how to apply for funding for any product or service. As john doe s therapist at the sam smith school, i am requesting that john be awarded funding to have an adaptive rifton tricycle for use at home. Athlete's medical clearance letter athletes usually go under a medical test to examine download or preview 1 pages of pdf version of sample letter of medical necessity and medical clearance for bariatric surgery (doc: