Hardship Letter Wisdom Teeth

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

{Date}

Dear Dr. {Name}:

My dentist {Name} recommended you as the best oral surgeon in the region. I am writing in the hopes that you will be able to work with my on a payment plan to remove all four of my wisdom teeth. They have become very painful, and as Dr. {Name} explains in the attached letter, it is imperative that they are removed as soon as possible to avoid infection, tooth shift, and other issues. {Explain emergency}. The dentist described my case as "high risk," and thus I cannot avail myself of options such as traveling to a dental school or staggering removal of the teeth.

Unfortunately, I have very little cash on hand, and have been refused when I applied this week for dental care credit via {Company} and {Company}. When I called your office, I was told that extraction of all four wisdom teeth costs in the {dollar amount} range. I only have about half that amount. Could you possibly see your way clear to allow me to make a down payment of {dollar amount}, followed by monthly payments of {dollar amount}? You have my word that I would not betray your trust.

Thank you for your consideration,

{Sender Name}

Index of Hardship Letter Examples