August 3, 2009

            Re:      Closure of Potter Valley Community Health Center

Dear Patient:

It is with deep regret that after twenty-seven years of operation, Potter Valley Community Health Center is being forced to close its doors.  This decision has been made as the inevitable result of the Governor’s recent decision to eliminate critical funding for uninsured patients seen by Potter Valley, coming on the heels of repeated rounds of cut to state funding of health care services for rural and underserved patients. 

We wish to thank you for your loyalty, however, effective August 21, 2009, we will be closing our doors and will no longer be able to provide health care services to you or your family after that date. 

If you need help in finding another health care provider, you may wish to call one of the Providers listed on our “Neighboring Health Centers and Dental Offices” page.  In addition, if you receive health care coverage under Medicare, Medi-Cal, Healthy Families, or another health care service plan, you may wish to check with your plan to obtain the name of participating providers.  Depending on your coverage, your choice of physician, dentist or other health care provider may be restricted.

If you would like would like copies of your records, or wish to have your records transferred to another physician, you must complete the Medical Release Form.  A reasonable charge may be made to cover costs of copying the records.  Records not transferred to another provider or picked up by patients will be destroyed in accordance with Potter Valley’s record retention policy. All records of patients seen within the past seven (7) years or patients seen as children and currently up to twenty-five (25) years of age will be released to the Mendocino Community Health Clinic as Custodian of Medical Records for the Potter Valley Community Health Center.

Please complete and return the Medical Release form as soon as possible, and return to
Mendocino Community Health Clinic
c/o Custodian of Medical Records for the Potter Valley Community Health Center
333 Laws Avenue
Ukiah, CA 95482

                                                Sincerely,

                                                POTTER VALLEY COMMUNITY HEALTH CENTER