Sample Letter for Hormone Therapy Mobile App

Included Fields

Customize to add, remove, or edit any of the fields below.

• 

  Date

• 

  Name

• 

  Address

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  Phone Number

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  To Whom It May Concern:

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  [Legal Name]

• 

  [Date of Birth],

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  is a [Age] year old

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  individual who has established a longstanding and strong identity.

• 

  [Legal Name]

• 

  reports a prior history of anxiety which appears to have been in response to the stressors during...

• 

  [Legal Name]

• 

  seems to have significant progress in her/his/their (or preferred pronoun) transitioning and seem...

• 

  I met with [Legal Name]

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  for an evaluation on [date of evaluation].

• 

  [Therapist Phone Number].

• 

  Sincerely,

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  [Therapist Name],

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  [Signature]

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  [Qualifications]

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  *Note: Name to be used throughout the letter should be the client’s legal name.

• ...and More!