Great Lakes Medical PC

Re: Notification of Discontinuance of Medical Practice

Please be advised that because of events out of our control, we are discontinuing the practice of medicine for Great Lakes Medical, P.C. effective on September 5, 2015. After that date, we will not be able to attend you professionally.

We suggest you arrange to place yourself under the care of another physician. If you are not acquainted with another physician, I suggest that you contact the Michigan Board of Medicine or the physician referral service of the hospital of your choice, or, if you are a member of an HMO or other managed care organization, the physician directory of that organization. Once you have identified a physician or physicians you are considering selecting, be sure to check with your insurer or managed care organization to verify that his or her services are covered by your health plan. In the event a medical emergency arises in the interim, please remember that assistance is always available at the Emergency Department of the hospital nearest you.

We shall make my records of your case available to the physician you designate. However, since your medical records are confidential, we require your written authorization to make them available to another physician. For this reason, I have enclosed an authorization form. Please complete the form and return it to me within thirty (30) days. As you will see on the enclosed form, please indicate whether you (1) request a copy of your records; or (2) direct the transfer of your records to your new doctor or another physician or health care facility (and provide the name of the physician you wish me to transfer the records to); or (3) request that the records be destroyed. If you do not respond within thirty (30) days, I will be transferring your records to a secure storage facility.

In the event you need information after the practice is closed, please contact:

Scott Lester

Fax: 989.709.5350

slester@macauleymedical.com

I regret that I cannot continue as your physician. I extend to you my best wishes for your future health and happiness.

Sincerely,

GREAT LAKES MEDICAL, P.C

Richard W. MacAuley, MD

Director

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