I need a sample letter for my PCP to write of Medical Necessity

I have a new PCP here in the state of FL.I have only seen him once. I need to get my Dr.'s in Tenn. to write me a letter of Medical Necessity and they both said if I could fax them a rough draft of what I need they would re-write it and fax it back to me. So I am begging for your help. If anyone out there could help me with a rough draft I would greatly apperciate it. Thank you so much.

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