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Basically it goes like this
“Dear Mr Mann,
I would appreciate if you could arrange for to review Danielle in relation to her background history of Endometriosis. Danielle has been suffering (brief list symptoms) and ongoing pain since (date). (If you have had previous failed surgeries just state that). Danielle heard of your expertise through the Endometriosis Association of Ireland. I would be grateful for your review.
Hope this gives you an idea!