Parent and Caregiver Handbook for Sickle Cell
Appendix: Doctor letter to schools about physical education (template)
For your convenience, download this template (Word)ā. You can
edit it with your own information.ā
Re: [Patient Name]
MR#: [MR#]
DOB: [Date of Birth]
Date: [Today's Date]
To Whom It May Concern:
The above-named patient is a(n) [age of child]-year-old followed at āā[Clinic or Hospital] for sickle cell disease. She/he is capable of normal participation in a general physical education program, and we would encourage this as much as possible.
However, because of his or her sickle cell disease, there are times when the patient may experience pain in the limbs, shortness of breath or other symptoms with strenuous physical activity. She/he should be excused from such activity at these times, but alternatives should be sought which will allow as much participation as possible in group activities, without forcing the child beyond these temporary limitations.
If you have any questions, please feel to contact me at [āClinic, Hospital, or Doctor Contact Information].
Sincerely,
[Name of Doctor or Nurse]
[Telephone Number/Contact Information]
āThis template is provided courtesy of the University of San Francisco, Benioff Children's Hospital Oakland Sickle Cell Center.ā