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SEER Training Modules

Sample Follow-up Letter #1

Letter to Physicians

To: James Smith, M.D.
123 Any Street
Anytown, XX 9999

Date of letter: 1/1/02

Last follow-up date:
Other hospital #

From: John Doe, MD
Chair, Cancer Committee

Re: Doe, Jane Mary
Date of birth: 1/1/40
Diagnosis: Breast CA
TR#: 910123/00
(Accession and Sequence)

An annual follow-up of registered cancer cases seen at Anytown Medical Center is conducted by the Cancer Registry. We would appreciate receiving the latest information you have on the patient listed above. Please direct questions to the Cancer Registry at (999) 555-9999.

Patient Status:

  1. Alive

    Date last seen or contacted:
    ___________________________________________________________

    1. Status of Neoplasm
    2. Quality of Survival
    3. Additional therapy within the last year

      Patient Referred to:
      ______________________________________________________

      New patient address:
      ______________________________________________________

      Comments:
      ______________________________________________________

  2. Expired

    Place:
    ___________________________________________________________

    Date:
    ___________________________________________________________

    Cause of Death:
    ___________________________________________________________

    Autopsy: Yes _______ No _______