HomeSolicitation LettersSOLICITATION LETTER FOR MEDICAL ASSISTANCE

SOLICITATION LETTER FOR MEDICAL ASSISTANCE

This sample letter aims to help a sick person by requesting medical assistance in your local government office. You can even use this letter to a private company or any association.

Indicate your financial situation with the medical request for your sickness or disease. Include your proof of income monthly as a reference, and bring the medical records with your valid ids.

solicitation-letter-for-medical-assistance-template

Solicitation Letter For Medical Assistance

SAMPLE

Sarita Joelle M. Olarte
Roxas Avenue, Mahayahay
Iligan, Lanao del Norte

April 29, 2017

Mayor Josef F. Francisco
Office of the Mayor
Dasmariñas City, Cavite
4114

RE: Requesting medical assistance for disease

Dear Mayor Josef F. Francisco,

I want to request medical assistance with your good heart for purchasing my medication for my diabetes. Our financial situation has been difficult since I was diagnosed with diabetes: my specialist Dr. Julian Forrest I. Rioja prescribed medicine to me on April 25, 2017.

I struggled because I could not buy my daily maintenance for my diabetes. My fixed retirement income is insufficient to afford my maintenance medicine because it is too expensive. I appreciate your medical assistance at any cost, and it’s a big help for me to continue my everyday activities.

I’m sharing my medical records and application form stating all the medicines required daily here. Also, I have held my last two bank financial statements and see that my treatment cost cannot afford my monthly income.

Thank you for accommodating my request letter. Suppose you have any questions and verification regarding my letter and documents. Please don’t hesitate to reach me at my contact number 0916-123-4567.

I hope for your favorable reply soon.

Sincerely yours,
Sarita Joelle M. Olarte




FORMAT

[NAME]
[ADDRESS]

[DATE]

[RECIPIENT NAME]
[LOCAL GOVERNMENT OFFICE]
[ADDRESS]
[ZIPCODE]

RE: Requesting medical assistance for disease

Dear Mayor [RECIPIENT NAME],

I want to request medical assistance with your good heart for purchasing my medication for my [SICKNESS]. Our financial situation has been difficult since I was diagnosed with [SICKNESS]: my specialist Dr. [NAME OF THE DOCTOR] prescribed medicine to me on [DATE].

I struggled because I could not buy my daily maintenance for my [SICKNESS]. My [REASON] income is insufficient to afford my maintenance medicine because it is too expensive. I appreciate your medical assistance at any cost, and it’s a big help for me to continue my everyday activities.

I’m sharing my medical records and application form stating all the medicines required daily here. Also, I have held my [PROOF OF INCOME] and see that my treatment cost cannot afford my monthly income.

Thank you for accommodating my request letter. Suppose you have any questions and verification regarding my letter and documents. Please don’t hesitate to reach me at my contact number [CONTACT NUMBER].

I hope for your favorable reply soon.

Sincerely yours,
[SIGNATURE]
[NAME]

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