MH Letters and Forms

Use these MH Letters and Forms to aid in discussions/education about Malignant Hyperthermia with your family, healthcare professionals, schools, and insurance companies. You may also order a hard copy of some to be shipped to you, from our online store.

SAMPLE LETTER: CHCT Test Form: PDF Format.

SAMPLE LETTER: Letter of Medical Necessity to insurance company: Use to request prior authorization for genetic testing from insurance companies. PDF format.

SAMPLE LETTER: Notify Healthcare Facility of MH-Susceptibility: This is a sample letter an MH-susceptible individual could send to his/her local hospital(s). Its purpose is to advise the hospital(s) there is an MH-susceptible individual/family in the area and to determine whether the hospital is adequately prepared to treat MH. PDF format.

SAMPLE LETTER: Notify Insurance Company of Muscle Biopsy for MH: Sample letter to insurance company, explaining the reasons for and the implications of the muscle biopsy requested. PDF format.

SAMPLE LETTER: Request for Medical Records: Sample letter to the hospital's medical records department. PDF format.

SAMPLE LETTER: Information about MH genetic testing for insurance company: Use to aid discussions about Malignant Hyperthermia with insurance companies. PDF format.

SAMPLE LETTER: MH Susceptible Student Care Plan: Malignant Hyperthermia student care plan for schools. PDF format.

SAMPLE LETTER: MH Susceptible Student Guide for Teachers: The Malignant Hyperthermia susceptible student - a guide for teachers. PDF format.

SAMPLE LETTER: Notify Family Of MH-Susceptibility: Sample letter to family members regarding susceptibility to MH. PDF format.

SAMPLE LETTER: Patient Safety Checklist: Questions to help you prepare for a patient's upcoming procedure.