Is a letter of self report the same as a letter of necessity?

I have an appt to see the nurse on Aug 5th. I am to bring a letter I have written myself to this appt stating how obesity is affecting my health, mental well-being and quality of life. Also how I expect my life to change after surgery and why I think I would make a good candidate. Will this go to the insurance company, or just the nurse? Should I write it as if it will go to insurance? If so and they want a letter of their own later what would I say?

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