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Advocacy Letters for Children
Education Accommodation Plans - Overview
(Adobe PDF File)
Sample School Accommodation Letter
(Microsoft Word Document)
II. Patient assistance plans that help with medication financing and medication copays
•Sample Letter - Patient Assistance
(Microsoft Word Document)
III. Legally sanctioned work absences without fear of losing one’s job under the Family and Medical Leave Act
Family Leave Act - Overview
(Adobe PDF File)
Sample Letter - Family Leave Act
(Microsoft Word Document)
IV. Letters of medical necessity that inform an insurance company of the need for a particular treatment.
Letter of Medical Necessity for Coverage for Fecal Calprotectin to Monitor Disease
(Microsoft Word Document)
Letter of Medical Necessity for Fecal Calprotection to Screen for IBD
(Microsoft Word Document)
Letter of Medical Necessity for Dose Escalation or Alteration of Anti-TNF Therapy
(Microsoft Word Document)
Letter of Medical Necessity for Therapeutic Drug Monitoring
(Microsoft Word Document)
Sample Appeal Letter - Capsule Endoscopy
(Microsoft Word Document)
Sample Appeal Letter Adalimumab Therapy
(Microsoft Word Document)
Sample Appeal Letter - Medication
(Microsoft Word Document)
If you or your team requires additional help with these issues,the following resources are available:
Advocacy for Patients with Chronic Illness
- (
Jennifer Jaff, Esq
).
Know your Rights: A Handbook for Patients with Chronic Illness (2008 edition)
. or
www.Amazon.com
.
Additional downloadable letters are available on the
Crohn’s and Colitis Foundation’s
Website in the professionals section.
The materials have been prepared by the NASPGHAN Inflammatory Bowel Disease Committee
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