Hardship Letter Orthodontist Braces

{Your Name}
{Your Address}
{Your Phone #}

{Date}

Dear Dr. {name}:

It is with great regret and embarrassment that I am writing to let your office know that I will not be able to make this month's agreed-upon payment of {amount} for {name}'s braces.

Recently, due to {explain personal/financial setback}, we have found ourselves far short of the amount needed to meet our day-to-day financial responsibilities. Other than basic food and shelter, we have fallen behind on nearly all of our bills.

However, {hopeful development}, so I have every reason to believe that this setback is temporary and that I will be able to resume regular payments, and make up for any missed payments, {timeframe}.

Please know that our entire family truly appreciates the care you have given {name} and it was never my intent to break trust or disrespect the credit extended to me by your office. I realize I'm in violation of the agreement that I signed when treatment started.

I hope that you will see your way clear to continue to treat {name}. She is not due to get her braces removed until treatment is complete, {date}. I am confident that my debt to you will be paid in full well before that time arrives. If you are able to waive late fees, that would be wonderful, but I understand if you cannot.

{Name} appreciates her braces so much and I know they will be life-changing for her. Thank you so much for all you've done for our family.

Thank you,

{Sender Name}

Index of Hardship Letter Examples