Example Study Recommendation Letter #1 (Pediatric) (Page 8 of 8) in pdf

symptoms manifested in a [condition] carrier.

2. [Protease] levels are chronically high, but not high enough for [condition]/

3. [He/she] tests relatively normal on most blood and urine diagnostics, but with some

curious exceptions: high on [tests]. Low on [tests].

4. [Medication] has a minor positive effect on [his/her] symptoms and [he/she] takes it on

an ongoing basis. This is the most helpful of the 100 or so medications that have been

tried.

5. [He/she] has idiosyncratic negative reactions to many medications, often responding to

“subclinical” doses.

6. [Name] was on a course of the medication [medication name] when [his/her] illness

started, but there are no other documented cases of such a reaction to this medication.

7. A number of surgical sympathetic blocks have been implemented on a temporary basis,

sometimes with great beneficial effect and sometimes the opposite.

8. Her illness bears some similarity to [condition], itself a rare and largely unexplained

disease. However, [condition] affects the feet and sometimes the hands, and there is little

or no reference in the literature to a similar disease affecting only the face.

Records: [Name] has carefully retained and organized the voluminous diagnostics and reports

on [his/her] condition over [time] years seeking a diagnosis and treatment. This should be

helpful to your efforts.

My role: While I am a [specialist] in private practice, I have served as [his/her] primary physician

since very early in the illness. I would be pleased to support your efforts and provide follow-up. I

understand that several other physicians that regularly see [name] are also in support of [his/her]

application and would be available to communicate with you if requested.

Patient’s perspective: [Name] has been exhaustive and courageous in seeking an explanation for

this illness. [He/she] read about your program in [magazine]. [He/she] fully understands that your

program is primarily for research purposes and that the chances of significant benefits from

participating are rather small. Please consider [him/her] for your program. My contact

information and [his/hers] appears below.

Sincerely,

Healthcare provider signature

[Healthcare provider name]

Letter #4, Page 2

Example Study Recommendation Letter #1 (Pediatric) Page 8