Fac-simile lettera per controlli doganali da compilare su carta intestata a cura del medico del Centro Emofilia di riferimento
To Whom It May Concern,
The bearer of this letter, _________________ (patient’s name), has a bleeding condition called haemophilia, caused by a deficiency of blood-clotting factors, which may result in both spontaneous bleeding episodes and prolonged bleeding following injury._______________ (patient’s name) is traveling to_________________. Traveling would not be possible without a supply of concentrates to control bleeding.
In the event of a bleeding episode, whether internal or external,_______________ (patient’s name) relies on prompt infusion of replacement coagulation factor concentrate to control the bleeding. S/he must, therefore, carry sufficient units for self-infusion. S/he also carries syringes, needles, and other supplies necessary for infusion.
Confiscation or withholding of either medication or equipment may place the bearer’s life in jeopardy. For example, this would be similar to withholding insulin from a person with diabetes.
I would request your cooperation in ensuring that s/he can keep both the medication and the administration kit with him/her at all times.
(Doctor’s signature, name, position)