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Resources: Sample Travel Letter for Tube and IV Consumers
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Sample Travel Letter for Tube and IV Consumers

Click on the links below to download a copy of the following sample letters in MS Word:

For help translating your letter into a foreign language try: www.babelfish.com or www.freetranslation.com


Sample Letter for Tube-fed Consumer

    Date   

To Whom It May Concern:

My patient,        patient name       , requires specialized nutrition support to sustain     his/her     life.      He/She     has an enteral feeding tube placed in     his/her     abdomen and sustains    his/herself    by pumping a nutritional formula through this tube.

** If you will need to pump formula during the flight add:  Because of     his/her     medical condition,     he/she     will need to infuse formula through     his/her    tube during the flight.

     He/She    may be traveling with any combination of the supplies listed below:

  • Feeding pump
  • Canned formula
  • Syringes
  • Tubing and feeding bags, etc.

These supplies are medically necessary and could be difficult to obtain while     he/she    is away from     his/her    local physicians and suppliers; therefore I request that     he/she    be allowed to carry them with     him/her    .

Please do not hesitate to contact me at (_____) _____ – ________ if you have any questions or need additional information.

Very sincerely,

    physician’s name  

    physician’s title   


Sample Letter for IV-fed Consumer

    Date   

 To Whom It May Concern:

My patient,     patient name    , requires specialized nutrition support to sustain     his/her     life.    He/She     has a central venous catheter placed in     his/her         chest/neck/arm/leg    and sustains     his/herself     by pumping a nutritional formula through this catheter.

** If you will need to infuse during the flight add:  Because of     his/her     medical condition,     he/she     will need to infuse fluids through     his/her     catheter during the flight.

    He/She    may be traveling with any combination of the supplies listed below:

  • Feeding pump
  • Intravenous (IV) formula
  • Syringes
  • Vials that contain vitamins and other additives/flushes
  • Tubing, connectors, dressings, etc.

These supplies are medically necessary and will be difficult to obtain while ___he/she___ is away from ___his/her___ local physicians and suppliers; therefore I request that     he/she     be allowed to carry them with     him/her    .

Please do not hesitate to contact me at (_____) _____ – ________ if you have any questions or need additional information.

Very sincerely,

    physician’s name  

  physician’s title   

more Calendar

2/6/2017 » 2/10/2017
Feeding Tube Awareness Week

2/18/2017 » 2/21/2017
Oley exhibit at A.S.P.E.N.'s Clinical Nutrition Week

5/6/2017
Oley Regional Conference

This website is an educational resource. It is not intended to provide medical advice or recommend a course of treatment. You should discuss all issues, ideas, suggestions, etc. with your clinician prior to use. Clinicians in a relevant field have reviewed the medical information; however, the Oley Foundation does not guarantee the accuracy of the information presented, and is not liable if information is incorrect or incomplete. If you have questions please contact Oley staff.

 

Updated in 2015 with a generous grant from Shire, Inc. 

 

This website was updated in 2015 with a generous grant from Shire, Inc. This website is an educational resource. It is not intended to provide medical advice or recommend a course of treatment. You should discuss all issues, ideas, suggestions, etc. with your clinician prior to use. Clinicians in a relevant field have reviewed the medical information; however, the Oley Foundation does not guarantee the accuracy of the information presented, and is not liable if information is incorrect or incomplete. If you have questions please contact Oley staff.
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