Provided by:
Amjo Corp
PO Box 8304,
West Chester,
Ohio, 45069
Tel: 513-942-2770
Fax: 513-942-2771

The letter below should be written by your doctor on his or her stationery

Please PRINT a copy of this letter as a sample for your Doctor.

To Whom It May Concern:

I have prescribed a National Biological Panosol II Narrow Band UVB Phototherapy system for home therapy for JOHN Q PUBLIC. I have been treating this patient since [DATE] for Vitiligo.

JOHN Q PUBLIC has failed to respond to various conventional topical therapies; therefore, in (month) of (year), UVB Narrow Band therapy was initiated. This involves having the patient come to my office for a minimum of two or three times per week for exposure to Narrow Band Ultraviolet B light in gradually increasing increments.

The patient is responding well to this therapy, and currently is much improved. I anticipate that this therapy will be needed and will continue for an indefinite period of time, possibly a lifetime.

Since this treatment was started, JOHN Q PUBLIC has had approximately ___ ultraviolet light treatment sessions at my office, at a charge of $ each. This represents about $_____ that insurance has already invested in this therapy. It is my opinion that providing a UVB Narrow Band light unit at home will save the insurance company a substantial amount of money in the long run. It will also significantly reduce the hardship my patient experiences in getting to and from my office two or three times a week.

The National Biological Corp Panosol II unit has the same potential as the ultraviolet light units used in my office and other treatment centers for Vitiligo. This unit is designed for home use.

I would like to specifically point out that the prescribed unit is designed for high intensity phototherapy and far exceeds the capabilities of the standard sun lamp.

If you have any further questions regarding JOHN Q PUBLIC's need for this specific form of therapy, please do not hesitate to contact me.

Sincerely,
(Doctor's signature)
 

BOLD UNDERLINE TEXT SHOULD BE EDITED/CHANGED BY THE WRITER

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