Physician Letter Of Intent Template

Information you will need

• On what date is this letter being drafted?
• Who's sending this letter?
• What's the sender's street address?
• What's the sender's city, state, and ZIP code?
• Who's receiving this letter?
• What's the recipient's street address?
• What's the recipient's city, state, and ZIP code?
• What’s the subject of the letter?
• Who is this letter addressed to?
• What's the physician's name?
• What's the start date?
• What's the end date?
• How will this agreement be terminated?
• How many days’ notice is required to terminate?
• When this agreement end?
• What services will the physician perform?
• How many days per week is the physician expected to work?
• How many hours per day is the physician expected to work?
• What's the physician's base salary?
• What's the physician's sign on bonus?
• Will the employer reimburse relocation costs?
• What’s the maximum relocation amount?
• Will the employer reimburse temporary housing costs?
• What’s the maximum temporary housing amount?

…and 26 more fields in the PDF.

Completed by the employer.

The form includes 2 signature lines.