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[Date of letter-month, day, and year]

[Recipient's first and last names]
[Company name]
[Street or P.O. box address]
[City, State ZIP code]

Dear [recipient's name]:

I am writing to you regarding a situation that arose recently when I saw one of your staff doctors, Dr. Roger Simmons. On February 28th, I saw Dr. Simmons for a follow-up appointment in the clinic where he practices. At that time, he was extremely rude and abrupt and refused to answer my medical questions. This was completely unacceptable to me.

Please contact me so that I can further discuss this matter with you. I would also like to discuss with you the possibility of transferring my care from Dr. Simmons to one of your other doctors. I look forward to hearing from you, and thank you in advance for helping me to resolve this important matter.

Sincerely,

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[Sender's first and last names]