<PracticeLetterhead>

<TodaysDate>

<AdrName>
<AdrAddress>
Phone: <AdrPhone>
Fax: <AdrFax>

Dear <AdrGreeting>,

Re:  Team Care Arrangements for  <PtFullName>,  DOB: <PtDoB>

The Commonwealth Government through the Enhanced Primary Care initiative aims to improve coordination of care and provide a more systematic approach to the care of patients with chronic conditions and complex care needs.  One component of this initiative provides GPs with an opportunity to develop multidisciplinary Team Care Arrangements for these patients.

I am currently developing Team Care Arrangements for the above patient who has given consent to include you as a member of the team.  Attached is a copy of the plan.

I would be grateful if you could advise me:
a) Whether you are willing to be involved in the Team Care Arrangements for this patient?
b) Whether you are satisfied with the plan or have any suggestions for changes to the Team Care Arrangements?

I would appreciate your feedback either by phone or by completing the details below and faxing this page back to me.  If you are happy with the plan all you need to do is to fax this page back and send feedback as per usual after you have seen the patient.

Yours sincerely

_____________________________________________________________________

Communication re Team Care Arrangement
I, <AdrName>, in reference to the Team Care Arrangements for this patient
(Please tick box as appropriate)
   I am willing to be involved in the Team Care Arrangements, and I am satisfied with the plan as it is.
or
   I am willing to be involved in the Team Care Arrangements, and I would like to make some changes to the plan (please attach your suggested changes).

Signature: ………………………………………….		Date:  …../…../…..