Refund for Endodontic Treatment
City, State ZIP
(or preferably print on letterhead)
City, State Zip
As we discussed at your recent appointment, we have attempted to save your problem tooth with a root canal treatment. Although root canal treatment has a high success rate, it is not 100%. Unfortunately yours was one of those that did not respond to the treatment.
I would like to return the payments that you have made to date for this endodontic procedure. Please find the enclosed check for $xxx.xx. Although many dentists do not do this, I am choosing to return your payments in order to maintain the good relationship we have developed.
As a reminder, I have referred you to Dr. ________, an endodontic specialist, for consultation about whether or not specialized treatment might help the tooth. Please do not delay this, as it will further decrease the chances of successful treatment.
As a reminder, I have referred you to Dr. ________, an Oral Surgeon specialist, to discuss removal of the tooth and possible implant replacement.