Diabetes A1C Test Template – Providers can mail to patients

<Date>

< First Name> <Last Name>

< Address1>

<Address2>

<City>, <St> <Zip>

Dear < First Name> <Last Name>,

I recently reviewed your chart, and it appears that you have not had your A1C done yet this year. As a diabetic, this test is very important to have done routinely. The A1C reflects your average blood sugar level over the last three months. This helps me determine the best course of treatment for your diabetes.

I have included a prescription for you to have this simple blood test done. If you have any questions or need help finding a place to have this done, please call the office and we can help with this.

Sincerely,

<Physician Name>

<Title>

Practice Name and Logo

Frederick, Seana M

2020-04-14

Butler, Sandy (Highmark Inc)

Highmark Health Solutions Inc