Date: ___________
To Whom It May Concern,
_____________________ is a patient of mine at ________________. My
patient has osteogenesis imperfecta (OI), a genetic disorder that
causes bones to be very weak and break easily.
In addition to bone fragility, my patient also has the following
symptoms related to the disease:
___________________________________________________________________
___________________________________________________________________
My patient should not participate in contact sports. Other types of
activities that should be avoided include:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
The following activities are permitted for my patient:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
In patients with OI, bone fractures are almost always the result of
accidental injuries, and not child abuse. Please call if you need
more information or have any concerns. Our phone number is
____________________.
Thank you for assisting my patient.
_______________________________________________
Physician
Written by Robert Brayden, MD, Associate Professor of Pediatrics, University of Colorado School of Medicine.
This content is reviewed periodically and is subject to
change as new health information becomes available. The
information is intended to inform and educate and is not a
replacement for medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
Copyright © 2006 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved.
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