Letter request for medical report from Dr

Letter — request for medical report on employee from doctor
[insert date]
[insert name and address of doctor]
Dear [insert doctor’s name]
Request for medical [examination and] report on [insert employee’s name]
This letter confirms our [request/instructions] to you to produce a report on the medical condition of your patient and our employee [insert name].
We also confirm our arrangement for you to examine them at [ ] am/pm] on [insert date] at [insert address].
We enclose a form they have completed consenting to:
• [our obtaining a medical report from you]
• [undergo a medical examination by you]
• [your being given access to their medical records by their general/specialist medical practitioner [insert name• ] of [insert address• ]]
• [your discussing your findings with us after producing your report]
• the processing of their sensitive personal data required in order to carry out the above, as required under the Data Protection Act 1998
We have given them a statement of their rights under the Access to Medical Reports Act 1988, including their right to change their mind about viewing the report before it is sent to us. They have decided that they do [not] wish to see the medical report before it is sent to us [and understand that they need to contact you within 21 days to arrange to view the report]. We are also sending them a copy of this letter.
Please include consideration of the following matters within the scope of your [examination/report]: [insert specific questions]
[We would be grateful for an early indication of the likely timescale involved in producing your report] We look forward to receiving it as soon as possible, together with a note of your fees.
Please feel free to contact me if I can be of further assistance.
Yours sincerely
[insert name]
For and on behalf of [insert name of employer]