Sample Letter Against Medical Advice

If you would like to leave a medical institution against medical advice, here is a sample letter against medical advice.



[Recipient Name]

Subject: Leaving Against Medical Advice

Dear [Name],

I am writing this letter to certify that I, [enter name], a patient at, [enter hospital’s name] suffering from [enter illness], want to leave against the medical advice of my doctor[s].

I am well aware of my medical conditions’ risks/benefits, and I truly understand them. I hereby release all the medical staff from the responsibility for all the consequences that might occur because of my leaving under these circumstances.


[Your Name]

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