Please note, some of the examples in the Appendices may be outdated and may have changed. Those changes may not be reflected in this document.

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Example 1: Courtesy of New York City Department of Health and Mental Hygiene Bureau of STD Control (in English and Spanish)


Dear <<screenname>>,

**This email is intentionally vague in order to protect your privacy. **

I am contacting you about an urgent health matter. It is most important that you report to the ________________ Health Center located at _____________.

Please print a copy of this email and bring it with you as it can reduce your waiting time. If you are unable to bring a copy of the email please let the health center staff know that you were contacted by me and asked to visit the clinic. If you have any questions regarding this notice, please feel free to contact me at [(XXX) XXX-XXXX] office or [(XXX) XXX-XXXX] cell Monday through Friday from 8:30 a.m. to 3:00 p.m.

Services at the health center are free and confidential. If you prefer to consult a private physician, please ask him or her to contact me for information on the health matter I am contacting you about.

If I am not available at the time of your call, please leave a number and time when I can reach you. My voicemail is private, confidential, and password-protected.

This email is intentionally vague in order to protect your privacy. Please visit the health center or contact me by telephone for more information.


[insert PHA name]

Program Name

Email:[insert PHA email]

IMPORTANT NOTICE: This email is meant only for the use of the intended recipient. It may contain confidential information that is legally privileged or otherwise protected by law. If you have received this communication in error, please notify me immediately by replying to this message and please delete it from your computer. Thank you for your cooperation.

[FR #]



**Este correo electrónico es intencionalmente indefinido para proteger su privacidad.**

Estimado/a <<screenname>>:

Me estoy comunicando con usted sobre un asunto de salud urgente. Por favor visite el Centro de Salud de ________________ en _____________ tan pronto como sea posible. Cuando llegue a la clínica, muestre este correo electrónico o mencióneselo al personal de la clínica.

Los servicios en nuestras clínicas se ofrecen de manera gratuita y confidencial, pero si prefiere hablar con un médico privado, pídales que se comuniquen conmigo.

Si tiene alguna pregunta o necesita más información, responda a este correo electrónico, o comuníquese conmigo llamando al [XXX-XXX-XXXX] o [XXX-XXX-XXXX], de lunes a viernes, de 8:30 a. m. a 3:00 p. m. Si no estoy disponible, deje un mensaje de voz con su nombre, número de teléfono y la mejor hora para localizarle. Mi buzón de voz es privado, confidencial y está protegido por contraseña.


[insert PHA name]

Program Name

Email:[insert PHA email]

AVISO IMPORTANTE: Este correo electrónico está destinado solo para el uso del destinatario previsto. Este correo puede contener información confidencial que es legalmente privilegiada o está protegida por la ley de otra manera. Si usted ha recibido esta comunicación por error, notifíqueme de inmediato respondiendo a este mensaje y por favor bórrelo de su computadora. Gracias por su cooperación.


[FR #]





Example 2: Courtesy of San Francisco Department of Public Health


Internet Contact Letter #1 (Email letter and Handle letter)


My name is ___________________, and I work for the San Francisco Department of Public Health. Please contact me as soon as possible; you may have been exposed to an infectious disease. You will need to be examined, even if you do not feel sick.

Please call me at xxx-xxx-xxxx. If I am not at my desk, please leave me a message on my confidential voicemail with your name, phone number, and the best time to reach you.

We offer confidential screening and treatment at no cost at xxxx Street (between xxxx & xxxx). To be seen more quickly, please bring this letter with you when you come in and/or ask for me by name. Our drop-in hours are listed below.



Worker Name

Worker’s Title





** CONFIDENTIALITY NOTICE** This letter and any attachments are solely for the intended recipient and may contain confidential or privileged information. If you are not the intended recipient, any disclosure, copying, use or distribution of the information included in this message and any attachments is prohibited. If you have received this communication in error, please notify the sender immediately and permanently delete or otherwise destroy the information.