Date: ___________
To Whom It May Concern,
_____________________ is a patient of mine at ________________. My patient has osteogenesis imperfecta (OI), a genetic disorder that causes bones to be very weak and break easily.
In addition to bone fragility, my patient also has the following symptoms related to the disease:
___________________________________________________________________
___________________________________________________________________
My patient should not participate in contact sports. Other types of activities that should be avoided include:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
The following activities are permitted for my patient:
___________________________________________________________________
___________________________________________________________________
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In patients with OI, bone fractures are almost always the result of accidental injuries, and not child abuse. Please call if you need more information or have any concerns. Our phone number is ____________________.
Thank you for assisting my patient.
_______________________________________________
Physician