the main sections of a cover letter of application are

Parts of a Cover Letter: A Detailed Breakdown of 6 Must-Have Sections

3 takeaways

• Learn each part of a cover letter and proper cover letter structure
• Discover how to correctly write each section of your cover letter 
• The best method for generating personalized cover letters in seconds with the Teal AI Resume Builder

When you’re job searching, writing a cover letter can be one of the most discouraging tasks on the list. After all, you’ve already bookmarked the job you want, researched the company, and tailored the perfect resume to match the job description. 

And now, you need to find the time (and energy) to fit all that information into a single-page cover letter.

But by knowing all the parts of a cover letter, along with how to write them, you’ll have a massive head start in the application process. 

What are the parts of a cover letter?

Before you get started creating your cover letter sections, it's important to know the main parts of a professional cover letter. Here they are in order:

• Salutation (or greeting)
• Opening paragraph
• Closing paragraph

Struggling to land interviews with your current resume and cover letter? Get started with Teal’s AI Resume Builder today.

Just like there are resume sections , cover letters have sections, too.  So, first things first: should a cover letter have a header? Absolutely. 

More than just a list of ways to reach you, the header of your cover letter is your first branding opportunity. It should mirror the header of your resume to frame your application as a polished and cohesive package. 

This symmetry isn't just visually appealing; it shows a deliberate and meticulous approach to your job application.

But what should be on a cover letter header?

The key elements of a cover letter header include your:

• Email address
• LinkedIn URL (Optional)
• Phone number

Here’s an example: 

Consider adding a link to your professional online profile, like LinkedIn, especially if you’re applying for a remote job. 

Note: Even if you’re sending an email cover letter , you should attach your letter as a PDF. First, it’s just easier to format. Second, it helps the hiring manager print or share this document with other decision-makers. 

Following the date, you’ll want to add the:

• Name of the hiring manager 
• The company you’re applying to 

Here’s what this looks like: 

2. Salutation

When you’re on the hunt for a new job, first impressions matter. This is what makes the cover letter introduction or salutation so important.

This is where writing a personalized cover letter begins and where you demonstrate your interest and effort in connecting with the company on a human level. Directly addressing the hiring manager is highly recommended when you know their name. It signals respect, shows that you've done your homework, and positions you as a candidate who values personal engagement.

Why not just start your cover letter as “To whom it may concern”? 

Because in today's job market, where a lot of applications flood an inbox, a personalized greeting helps you stand out. It sets a tone of attentiveness and immediately tells the hiring manager that you pay attention to detail. 

Even this little gesture can transform a generic cover letter from a one-size-fits-all document into a tailored conversation starter that resonates with the person responsible for filling the role.

How to find the hiring manager's name

Finding the hiring manager’s name may seem difficult, but it’s often simpler than you think. 

Here are some strategies to uncover this key piece of information:

• LinkedIn : The professional network is your first port of call. Search for the company and sift through employee listings, focusing on those with titles like “Hiring Manager,” “Recruitment Officer,” or specific department heads if you’re applying for a specialized position.
• Company website : Sometimes, the information is hidden in plain sight on the company’s ‘Team’ or ‘About Us’ page. Larger companies might list their staff, job titles, and contact information.
• Calling in : A direct approach can be the most effective. Call the company’s front desk or HR department. Be polite, introduce yourself, and explain that you wish to address your cover letter appropriately. Most will be happy to help.
• Networking outreach : Rely on your network. Ask colleagues or mentors if they know who the hiring manager might be for the position you're eyeing. A mutual connection can often provide you with the name you need.
• Social media scan : Companies often post about their team and new hires on platforms like LinkedIn, Twitter, or Instagram. A quick search might yield the right name.

If you can’t find the hiring manager's name despite your best efforts, opt for a polite and general salutation like “Dear hiring manager” or “Dear hiring team” over the impersonal “To whom it may concern.” 

This retains a level of personalization and respect for the team's collaborative hiring effort. It also sets you apart from the many others who simply wrote: “to whom it may concern.”

Write the elements of a cover letter with Teal's AI

Before you start writing the main parts of your cover letter, consider using Teal instead.

Teal’s cover letter generator pulls from the information you added to a specific resume (also extracting the main keywords and details from the job posting you’re applying to) to align your content. Then, in just a click, you’ll have a great cover letter written before your eyes.

3. Opening paragraph

The opening paragraph of your cover letter is your chance to captivate the reader's interest and set the stage for your narrative. 

When it comes to your cover letter format , this section should include a succinct introduction of who you are, a brief mention of the position you’re applying for, and a compelling reason why the role aligns perfectly with your skills and career aspirations. 

How to grab your reader’s attention in the opening paragraph

To make your entrance memorable, the opening paragraph must do more than introduce – it must intrigue. Here’s how to ensure it does that:

• Start with a bang : Lead with a strong statement or a striking fact about your career achievements. Alternatively, a concise, bold expression of your enthusiasm for the company can be just as effective.
• Show, don't tell : Use a mini anecdote or a powerful example from your experience that reflects your capabilities and mirrors the values or needs of the company.
• Tailor your tone : Match the tone of your writing to the culture of the company. A startup might appreciate a more casual and innovative opener, while a traditional firm might respect a formal and straightforward approach.
• Add some flair : Add a touch of your personality without overshadowing your professionalism. Make sure it’s a blend that conveys your unique professional identity.
• Research results : Mention something recent about the company that impressed you, showing you’re up-to-date and genuinely interested in what they do.
• Give the why and the what : Clearly articulate why you’re excited about the role and what you bring to the table – this is your unique value proposition.

Example of cover letter content for an opening paragraph

“Imagine a marketing strategy so engaging that it doesn't just capture attention but creates a movement. That's been the hallmark of my approach as a Marketing Manager for the past decade, where I've increased brand engagement by an average of 65% year-over-year. Inspired by [Company Name]'s recent groundbreaking campaign on sustainability—a subject close to my heart since I was just a kid—I am eager to bring my expertise in crafting compelling narratives to the role of Head of Marketing.”

You can find more cover letter samples in these marketing manager cover letter examples .

What makes this a strong opening:

• Engages with storytelling: The opening verb is “Imagine,” which is much more engaging than something more traditional, like “My name is…”
• Quantifiable achievements: It includes a specific, measurable achievement (increasing brand engagement by 65% year-over-year), which adds credibility to the applicant’s claims and showcases a track record of success.
• Personal connection: There’s a personal touch with the mention of a lifelong passion for sustainability, making the applicant’s interest in the company feel genuine and deeply rooted.
• Alignment with company values: The reference to the company’s campaign on sustainability suggests that the applicant has done their research and shares the company’s values, implying a natural cultural fit.
• Focus on contribution: By stating a desire to bring expertise in crafting compelling narratives, the applicant immediately addresses how they can contribute to the company’s success rather than just what they wish to gain from the position.

If you can get all of those qualities to shine through in your cover letter, you’ll be more likely to get the reader over to the body of your cover letter. 

Your cover letter body is the meat of your message. It's where you dive into your professional journey, aligning your skills and experiences with the needs of the job at hand. 

This part should be structured in a clear and compelling manner, usually composed of one to three paragraphs, each serving a distinct purpose. 

The first paragraph should connect your past successes to the potential future contributions you'll make to the company. Subsequent paragraphs , like the second or third paragraph , can be used to go further into your relevant skills, experiences, and achievements while also reflecting your knowledge of the company’s goals and challenges.

How to showcase relevant skills and experiences

Here’s how to write a cover letter body that resonates with hiring managers:

• Customize and contextualize : Tailor each example of your experience to mirror the job description. It’s about relevance—show the reader why and how your background prepares you for the specific role.
• Quantify your impact : Use numbers and metrics to give weight to your achievements. Whether it’s increasing sales by a certain percentage or reducing costs through innovative solutions, numbers speak louder than words .
• Problem, action, result (PAR) method : For each skill or experience you share, present the problem you encountered, the action you took, and the result of your efforts. This method illustrates your thought process and problem-solving skills.
• Align with the company's vision : Show that you’ve done your homework by relating your experience to the company's current projects or goals. This demonstrates not just alignment but also initiative and forward-thinking.
• Storytelling with substance : Craft your experiences into a narrative that’s engaging. Your goal is to lead the reader on a journey that showcases growth, impact, and relevance to the role.
• Be concise, be clear : Avoid jargon and overly complex language. The body of your cover letter should be easy to read and understand, ensuring that your points are made without confusion.

Example of what should be in a cover letter body

During my tenure with XYZ Corp, a pioneer in eco-friendly packaging, I spearheaded a transition that faced significant initial resistance both internally and from our customer base. The challenge was formidable: to reframe the public's perception of sustainable packaging from a costly alternative to a savvy, consumer-driven choice. My strategy was to launch an educational campaign that highlighted not just the environmental impact but also the long-term economic benefits. This initiative not only garnered a 120% increase in consumer engagement but also positioned XYZ Corp as a thought leader in the market. In my most recent project, I led a cross-functional team to address a 15% slump in market share due to increased competition. By instituting a thorough competitor analysis and customer feedback loop, we identified key areas where our messaging fell flat. I orchestrated a brand revitalization campaign focused on our core strengths, infused with customer success stories. The result was a 25% market share rebound within the first quarter post-campaign. In each role, I've aligned my actions not only with the company's immediate goals but with a visionary outlook. For instance, anticipating the rise of AI in marketing, I initiated a successful pilot program at XYZ Corp that utilized machine learning to personalize customer interactions, leading to a 30% uptick in customer retention rates.

But remember, not every cover letter will focus on the same information. You’ll need to craft your cover letter according to the specific job you’re applying to. 

While this level of personalization may seem tedious, it’s absolutely necessary. 

5. Closing paragraph

One of the last main parts of a professional cover letter , the closing paragraph, isn’t just a summary but a strategic push to get you into the interview room. This part should reiterate your interest in the position, succinctly summarize why you’re the right fit, and express your enthusiasm about the potential to contribute to the company. 

It's also the place to include a call to action, such as expressing your desire to discuss your application in more detail in a personal interview.

How to end the cover letter on a strong note

• Reaffirm your value : Concisely restate how your skills and experiences align with the job and can benefit the company.
• Personal touch : Express genuine enthusiasm and confidence in your ability to perform the role. Let them feel your eagerness and readiness to take on the challenges it presents.
• Call to action : Encourage the hiring manager to take the next step. You can say you look forward to the opportunity to discuss how you can contribute to their team or that you're eager to provide further details on how you can help achieve their goals.

Closing paragraph example in a cover letter

I am excited to contribute to [Company Name]'s innovative marketing efforts. My skill set aligns seamlessly with the objectives of the Head of Marketing position. I am eager to apply my expertise in strategic planning and digital engagement to drive impactful campaigns that resonate with your brand's vision, and I look forward to discussing how my experience and insights can support your company's success. Thank you for considering my application, and I am hopeful for the opportunity to discuss collaboration in person.

If you're looking for more inspiration, check out this comprehensive database of 1300+ cover letter examples .

6. Sign-off

A professional sign-off sets the tone for how your cover letter is received. It's the equivalent of the final handshake after a successful meeting—it should convey respect and formality. 

Here's how you can ensure your sign-off strengthens your application:

• Choose the right closing : "Sincerely," "Best regards," and "Kind regards" are safe and professional options. If the company culture is more casual, "Best" or "Warm regards" may be suitable.
• Include your full name : Your sign-off should always include your full name to ensure clarity and formality. If you've established a personal connection with the hiring manager, adding a handwritten signature above your typed name can add a personal touch.
• Professional contact details : Beneath your name, include your professional contact details, such as your phone number and email address, and LinkedIn profile URL to facilitate easy follow-up.

The best way to write a cover letter 

Again, if writing a cover letter is your least favorite part of the job application, you’re not alone. It can be difficult to take all the bullet-point information from a resume and turn that into a single page of compelling and persuasive text. 

From getting the cover letter format just right to writing the actual information, it’s not an easy task. 

That’s why, with a tool like Teal’s cover letter generator , there’s simply no excuse for not having a personalized cover letter with each application. 

Simply build your resume, and with the click of a button, you can have a polished and personalized cover letter in seconds. 

Sign up for Teal today to give it a try!

Frequently Asked Questions

How long should each section of a cover letter be to maintain the reader's interest, can i include bullet points in the body of my cover letter to highlight my achievements, is it necessary to address the cover letter to a specific person, and what if i can't find a name.

Nathan Thompson

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How to write a great cover letter in 2024: tips and structure

A cover letter is a personalized letter that introduces you to a potential employer, highlights your qualifications, and explains why you're a strong fit for a specific job.

Hate or love them, these brief documents allow job seekers to make an impression and stand out from the pile of other applications. Penning a thoughtful cover letter shows the hiring team you care about earning the position.

Here’s everything you need to know about how to write a cover letter — and a great one, at that.

What is a cover letter and why does it matter?

A professional cover letter is a one-page document you submit alongside your CV or resume as part of a job application. Typically, they’re about half a page or around 150–300 words.

An effective cover letter doesn’t just rehash your CV; it’s your chance to highlight your proudest moments, explain why you want the job, and state plainly what you bring to the table.

Show the reviewer you’re likable, talented, and will add to the company’s culture . You can refer to previous jobs and other information from your CV, but only if it helps tell a story about you and your career choices .

What 3 things should you include in a cover letter?

A well-crafted cover letter can help you stand out to potential employers. To make your cover letter shine, here are three key elements to include:

1. Personalization

Address the hiring manager or recruiter by name whenever possible. If the job posting doesn't include a name, research to find out who will be reviewing applications. Personalizing your cover letter shows that you've taken the time to tailor your application to the specific company and role.

2. Highlight relevant achievements and skills

Emphasize your most relevant skills , experiences, and accomplishments that directly relate to the job you're applying for. Provide specific examples of how your skills have benefited previous employers and how they can contribute to the prospective employer's success. Use quantifiable achievements , such as improved efficiency, cost savings, or project success, to demonstrate your impact.

3. Show enthusiasm and fit

Express your enthusiasm for the company and the position you're applying for. Explain why you are interested in this role and believe you are a good fit for the organization. Mention how your values, goals, and skills align with the company's mission and culture. Demonstrating that you've done your research can make a significant impression.

What do hiring managers look for in a cover letter?

Employers look for several key elements in a cover letter. These include:

Employers want to see that your cover letter is specifically tailored to the position you are applying for. It should demonstrate how your skills, experiences, and qualifications align with the job requirements.

Clear and concise writing

A well-written cover letter is concise, easy to read, and error-free. Employers appreciate clear and effective communication skills , so make sure your cover letter showcases your ability to express yourself effectively.

Demonstrated knowledge of the company

Employers want to see that you are genuinely interested in their organization. Mention specific details about the company, such as recent achievements or projects, to show that you are enthusiastic about joining their team.

Achievements and accomplishments

Highlight your relevant achievements and accomplishments that demonstrate your qualifications for the position. Use specific examples to showcase your skills and show how they can benefit the employer.

Enthusiasm and motivation

Employers want to hire candidates who are excited about the opportunity and motivated to contribute to the company's success. Express your enthusiasm and passion for the role and explain why you are interested in working for the company.

Professionalism

A cover letter should be professional in tone and presentation. Use formal language, address the hiring manager appropriately, and follow standard business letter formatting.

How do you structure a cover letter?

A well-structured cover letter follows a specific format that makes it easy for the reader to understand your qualifications and enthusiasm for the position. Here's a typical structure for a cover letter:

Contact information

Include your name, address, phone number, and email address at the top of the letter. Place your contact information at the beginning so that it's easy for the employer to reach you.

Employer's contact information

Opening paragraph, middle paragraph(s), closing paragraph, complimentary close, additional contact information.

Repeat your contact information (name, phone number, and email) at the end of the letter, just in case the employer needs it for quick reference.

Remember to keep your cover letter concise and focused. It should typically be no more than one page in length. Proofread your letter carefully to ensure it is free from spelling and grammatical errors. Tailor each cover letter to the specific job application to make it as relevant and impactful as possible.

How to write a good cover letter (with examples)

The best letters are unique, tailored to the job description, and written in your voice — but that doesn’t mean you can’t use a job cover letter template.

Great cover letters contain the same basic elements and flow a certain way. Take a look at this cover letter structure for ref erence while you construct your own.

1. Add a header and contact information

While reading your cover letter, the recruiter shouldn’t have to look far to find who wrote it. Your document should include a basic heading with the following information:

• Pronouns (optional)
• Location (optional)
• Email address
• Phone number (optional)
• Relevant links, such as your LinkedIn profile , portfolio, or personal website (optional)

You can pull this information directly from your CV. Put it together, and it will look something like this:

Christopher Pike

San Francisco, California

[email protected]

Alternatively, if the posting asks you to submit your cover letter in the body of an email, you can include this information in your signature. For example:

Warm regards,

Catherine Janeway

Bloomington, Indiana

[email protected]

(555) 999 - 2222

2. Include a personal greeting

Always begin your cover letter by addressing the hiring manager — preferably by name. You can use the person’s first and last name. Make sure to include a relevant title, like Dr., Mr., or Ms. For example, “Dear Mr. John Doe.”

Avoid generic openings like “To whom it may concern,” “Dear sir or madam,” or “Dear hiring manager.” These introductions sound impersonal — like you’re copy-pasting cover letters — and can work against you in the hiring process.

Be careful, though. When using someone’s name, you don’t want to use the wrong title or accidentally misgender someone. If in doubt, using only their name is enough. You could also opt for a gender-neutral title, like Mx.

Make sure you’re addressing the right person in your letter — ideally, the person who’s making the final hiring decision. This isn’t always specified in the job posting, so you may have to do some research to learn the name of the hiring manager.

3. Draw them in with an opening story

The opening paragraph of your cover letter should hook the reader. You want it to be memorable, conversational, and extremely relevant to the job you’re pursuing. 

There’s no need for a personal introduction — you’ve already included your name in the heading. But you should make reference to the job you’re applying for. A simple “Thank you for considering my application for the role of [job title] at [company],” will suffice.

Then you can get into the “Why” of your job application. Drive home what makes this specific job and this company so appealing to you. Perhaps you’re a fan of their products, you’re passionate about their mission, or you love their brand voice. Whatever the case, this section is where you share your enthusiasm for the role.

Here’s an example opening paragraph. In this scenario, you’re applying for a digital marketing role at a bicycle company:

“Dear Mr. John Doe,

Thank you for considering my application for the role of Marketing Coordinator at Bits n’ Bikes.

My parents bought my first bike at one of your stores. I’ll never forget the freedom I felt when I learned to ride it. My father removed my training wheels, and my mom sent me barrelling down the street. You provide joy to families across the country — and I want to be part of that.”

4. Emphasize why you’re best for the job

Your next paragraphs should be focused on the role you’re applying to. Highlight your skill set and why you’re a good fit for the needs and expectations associated with the position. Hiring managers want to know what you’ll bring to the job, not just any role.

Start by studying the job description for hints. What problem are they trying to solve with this hire? What skills and qualifications do they mention first or more than once? These are indicators of what’s important to the hiring manager.

Search for details that match your experience and interests. For example, if you’re excited about a fast-paced job in public relations, you might look for these elements in a posting:

• They want someone who can write social media posts and blog content on tight deadlines
• They value collaboration and input from every team member
• They need a planner who can come up with strong PR strategies

Highlight how you fulfill these requirements:

“I’ve always been a strong writer. From blog posts to social media, my content pulls in readers and drives traffic to product pages. For example, when I worked at Bits n’ Bikes, I developed a strategic blog series about bike maintenance that increased our sales of spare parts and tools by 50% — we could see it in our web metrics.

Thanks to the input of all of our team members, including our bike mechanics, my content delivered results.”

5. End with a strong closing paragraph and sign off gracefully

Your closing paragraph is your final chance to hammer home your enthusiasm about the role and your unique ability to fill it. Reiterate the main points you explained in the body paragraphs and remind the reader of what you bring to the table.

You can also use the end of your letter to relay other important details, like whether you’re willing to relocate for the job.

When choosing a sign-off, opt for a phrase that sounds professional and genuine. Reliable options include “Sincerely” and “Kind regards.”

Here’s a strong closing statement for you to consider:

“I believe my enthusiasm, skills, and work experience as a PR professional will serve Bits n’ Bikes very well. I would love to meet to further discuss my value-add as your next Director of Public Relations. Thank you for your consideration. I hope we speak soon.

Tips to write a great cover letter that compliments your resume

When writing your own letter, try not to copy the example excerpts word-for-word. Instead, use this cover letter structure as a baseline to organize your ideas. Then, as you’re writing, use these extra cover letter tips to add your personal touch:

• Keep your cover letter different from your resume : Your cover letter should not duplicate the information on your resume. Instead, it should provide context and explanations for key points in your resume, emphasizing how your qualifications match the specific job you're applying for.
• Customize your cover letter . Tailor your cover letter for each job application. Address the specific needs of the company and the job posting, demonstrating that you've done your homework and understand their requirements.
• Show enthusiasm and fit . Express your enthusiasm for the company and position in the cover letter. Explain why you are interested in working for this company and how your values, goals, and skills align with their mission and culture.
• Use keywords . Incorporate keywords from the job description and industry terms in your cover letter. This can help your application pass through applicant tracking systems (ATS) and demonstrate that you're well-versed in the field.
• Keep it concise . Your cover letter should be succinct and to the point, typically no more than one page. Focus on the most compelling qualifications and experiences that directly support your application.
• Be professional . Maintain a professional tone and structure in your cover letter. Proofread it carefully to ensure there are no errors.
• Address any gaps or concerns . If there are gaps or concerns in your resume, such as employment gaps or a change in career direction, briefly address them in your cover letter. Explain any relevant circumstances and how they have shaped your qualifications and determination.
• Provide a call to action . Conclude your cover letter with a call to action, inviting the employer to contact you for further discussion. Mention that you've attached your resume for their reference.
• Follow the correct format . Use a standard cover letter format like the one above, including your contact information, a formal salutation, introductory and closing paragraphs, and your signature. Ensure that it complements your resume without redundancy.
• Pick the right voice and tone . Try to write like yourself, but adapt to the tone and voice of the company. Look at the job listing, company website, and social media posts. Do they sound fun and quirky, stoic and professional, or somewhere in-between? This guides your writing style.
• Tell your story . You’re an individual with unique expertise, motivators, and years of experience. Tie the pieces together with a great story. Introduce how you arrived at this point in your career, where you hope to go , and how this prospective company fits in your journey. You can also explain any career changes in your resume.
• Show, don’t tell . Anyone can say they’re a problem solver. Why should a recruiter take their word for it if they don’t back it up with examples? Instead of naming your skills, show them in action. Describe situations where you rose to the task, and quantify your success when you can.
• Be honest . Avoid highlighting skills you don’t have. This will backfire if they ask you about them in an interview. Instead, shift focus to the ways in which you stand out.
• Avoid clichés and bullet points . These are signs of lazy writing. Do your best to be original from the first paragraph to the final one. This highlights your individuality and demonstrates the care you put into the letter.
• Proofread . Always spellcheck your cover letter. Look for typos, grammatical errors, and proper flow. We suggest reading it out loud. If it sounds natural rolling off the tongue, it will read naturally as well.

Common cover letter writing FAQs

How long should a cover letter be.

A cover letter should generally be concise and to the point. It is recommended to keep it to one page or less, focusing on the most relevant information that highlights your qualifications and fits the job requirements.

Should I include personal information in a cover letter?

While it's important to introduce yourself and provide your contact information, avoid including personal details such as your age, marital status, or unrelated hobbies. Instead, focus on presenting your professional qualifications and aligning them with the job requirements.

Can I use the same cover letter for multiple job applications?

While it may be tempting to reuse a cover letter, it is best to tailor each cover letter to the specific job you are applying for. This allows you to highlight why you are a good fit for that particular role and show genuine interest in the company.

Do I need to address my cover letter to a specific person?

Whenever possible, it is advisable to address your cover letter to a specific person, such as the hiring manager or recruiter. If the job posting does not provide this information, try to research and find the appropriate contact. If all else fails, you can use a generic salutation such as "Dear Hiring Manager."

Should I include references in my cover letter?

It is generally not necessary to include references in your cover letter. Save this information for when the employer explicitly requests it. Instead, focus on showcasing your qualifications and achievements that make you a strong candidate for the position.

It’s time to start writing your stand-out cover letter

The hardest part of writing is getting started. 

Hopefully, our tips gave you some jumping-off points and confidence . But if you’re really stuck, looking at cover letter examples and resume templates will help you decide where to get started. 

There are numerous sample cover letters available online. Just remember that you’re a unique, well-rounded person, and your cover letter should reflect that. Using our structure, you can tell your story while highlighting your passion for the role. 

Doing your research, including strong examples of your skills, and being courteous is how to write a strong cover letter. Take a breath , flex your fingers, and get typing. Before you know it, your job search will lead to a job interview.

If you want more personalized guidance, a specialized career coach can help review, edit, and guide you through creating a great cover letter that sticks.

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Elizabeth Perry, ACC

Elizabeth Perry is a Coach Community Manager at BetterUp. She uses strategic engagement strategies to cultivate a learning community across a global network of Coaches through in-person and virtual experiences, technology-enabled platforms, and strategic coaching industry partnerships. With over 3 years of coaching experience and a certification in transformative leadership and life coaching from Sofia University, Elizabeth leverages transpersonal psychology expertise to help coaches and clients gain awareness of their behavioral and thought patterns, discover their purpose and passions, and elevate their potential. She is a lifelong student of psychology, personal growth, and human potential as well as an ICF-certified ACC transpersonal life and leadership Coach.

3 cover letter examples to help you catch a hiring manager’s attention

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How to Write a Cover Letter [Full Guide & Examples for 2024]

After weeks of heavy job searching, you’re almost there!

You’ve perfected your resume.

You’ve short-listed the coolest jobs you want to apply for.

You’ve even had a friend train you for every single interview question out there.

But then, before you can send in your application and call it a day, you remember that you need to write a cover letter too.

So now, you’re stuck staring at a blank page, wondering where to start...

Don’t panic! We’ve got you covered. Writing a cover letter is a lot simpler than you might think. 

In this guide, we’re going to teach you how to write a cover letter that gets you the job you deserve.

We're going to cover:

What Is a Cover Letter?

• How to Write the Perfect Cover Letter, Step by Step
• 15+ Job-Winning Cover Letter Examples

Let’s get started.

A cover letter is a document that you submit as part of your job application, alongside your resume or CV.

The purpose of a cover letter is to introduce you and briefly summarize your professional background. On average, it should be around 250 to 400 words long .

A good cover letter is supposed to impress the hiring manager and convince them you’re worth interviewing as a candidate.

So, how can your cover letter achieve this?

First of all, it should complement your resume, not copy it. Your cover letter is your chance to elaborate on important achievements, skills, or anything else that your resume doesn’t give you the space to cover. 

For example, if you have an employment gap on your resume, the cover letter is a great place to explain why it happened and how it helped you grow as a person. 

If this is your first time writing a cover letter, writing about yourself might seem complicated. But don’t worry—you don’t need to be super creative or even a good writer .

All you have to do is follow this tried and tested cover letter structure:

• Header. Add all the necessary contact information at the top of your cover letter.
• Formal greeting. Choose an appropriate way to greet your target audience.
• Introduction. Introduce yourself in the opening paragraph and explain your interest in the role.
• Body. Elaborate on why you’re the best candidate for the job and a good match for the company. Focus on “selling” your skills, achievements, and relevant professional experiences.
• Conclusion. Summarize your key points and wrap it up professionally.

Now, let’s take a look at an example of a cover letter that follows our structure perfectly:

New to cover letter writing? Give our cover letter video a watch before diving into the article!

When Should You Write a Cover Letter?

You should always include a cover letter in your job application, even if the hiring manager never reads it. Submitting a cover letter is as important as submitting a resume if you want to look like a serious candidate.

If the employer requests a cover letter as part of the screening process, not sending one is a huge red flag and will probably get your application tossed into the “no” pile immediately.

On the other hand, if the job advertisement doesn’t require a cover letter from the candidates, adding one shows you went the extra mile.

Putting in the effort to write a cover letter can set you apart from other candidates with similar professional experience and skills, and it could even sway the hiring manager to call you for an interview if you do it right.

Need to write a letter to help get you into a good school or volunteer program? Check out our guide to learn how to write a motivation letter !

How to Write the Perfect Cover Letter

Now that you know what a cover letter is, it’s time to learn how to write one!

We’ll go through the process in detail, step by step.

#1. Choose the Right Cover Letter Template

A good cover letter is all about leaving the right first impression.

So, what’s a better way to leave a good impression than a well-formatted, stylish template?

Just choose one of our hand-picked cover letter templates , and you’ll be all set in no time!

As a bonus, our intuitive AI will even give you suggestions on how to improve your cover letter as you write it. You’ll have the perfect cover letter done in minutes!

#2. Put Contact Information in the Header

As with a resume, it’s important to start your cover letter with your contact details at the top. These should be in your cover letter’s header, separated neatly from the bulk of your text.

Here, you want to include all the essential contact information , including:

• Full Name. Your first and last name should stand out at the top.
• Job Title. Match the professional title underneath your name to the exact job title of the position you’re applying for. Hiring managers often hire for several roles at once, so giving them this cue about what role you’re after helps things go smoother.
• Email Address. Always use a professional and easy-to-spell email address. Ideally, it should combine your first and last names.
• Phone Number. Add a number where the hiring manager can easily reach you.
• Location. Add your city and state/country, no need for more details.
• Relevant Links (optional). You can add links to websites or social media profiles that are relevant to your field. Examples include a LinkedIn profile , Github, or an online portfolio.

Then it’s time to add the recipient’s contact details, such as:

• Hiring Manager's Name. If you can find the name of the hiring manager, add it.
• Hiring Manager's Title. While there’s no harm in writing “hiring manager,” if they’re the head of the department, we recommend you use that title accordingly.
• Company Name. Make sure to write the name of the company you're applying to.
• Location. The city and state/country are usually enough information here, too.
• Date of Writing (Optional). You can include the date you wrote your cover letter for an extra professional touch.

#3. Address the Hiring Manager

Once you’ve properly listed all the contact information, it’s time to start writing the content of the cover letter.

The first thing you need to do here is to address your cover letter directly to the hiring manager.

In fact, you want to address the hiring manager personally .

Forget the old “Dear Sir or Madam” or the impersonal “To Whom It May Concern.” You want to give your future boss a good impression and show them that you did your research before sending in your application.

No one wants to hire a job seeker who just spams 20+ companies and hopes something sticks with their generic approach

So, how do you find out who’s the hiring manager?

First, check the job ad. The hiring manager’s name might be listed somewhere in it.

If that doesn’t work, check the company’s LinkedIn page. You just need to look up the head of the relevant department you’re applying to, and you’re all set.

For example, if you’re applying for the position of Communication Specialist at Novorésumé. The hiring manager is probably the Head of Communications or the Chief Communications Officer.

Here’s what you should look for on LinkedIn:

And there you go! You have your hiring manager.

But let’s say you’re applying for a position as a server . In that case, you’d be looking for the “restaurant manager” or “food and beverage manager.”

If the results don’t come up with anything, try checking out the “Team” page on the company website; there’s a good chance you’ll at least find the right person there.

Make sure to address them as Mr. or Ms., followed by their last name. If you’re not sure about their gender or marital status, you can just stick to their full name, like so:

• Dear Mr. Kurtuy,
• Dear Andrei Kurtuy,

But what if you still can’t find the hiring manager’s name, no matter where you look?

No worries. You can direct your cover letter to the company, department, or team as a whole, or just skip the hiring manager’s name.

• Dear [Department] Hiring Manager
• Dear Hiring Manager
• Dear [Department] Team
• Dear [Company Name]

Are you applying for a research position? Learn how to write an academic personal statement .

#4. Write an Eye-Catching Introduction

First impressions matter, especially when it comes to your job search.

Hiring managers get hundreds, sometimes even thousands, of applications. Chances are, they’re not going to be reading every single cover letter end-to-end.

So, it’s essential to catch their attention from the very first paragraph.

The biggest problem with most opening paragraphs is that they’re usually extremely generic. Here’s an example:

• My name is Jonathan, and I’d like to work as a Sales Manager at XYZ Inc. I’ve worked as a Sales Manager at MadeUpCompany Inc. for 5+ years, so I believe that I’d be a good fit for the position.

See the issue here? This opening paragraph doesn’t say anything except the fact that you’ve worked the job before.

And do you know who else has similar work experience? All the other applicants you’re competing with.

Instead, you want to start with some of your top achievements to grab the reader’s attention. And to get the point across, the achievements should be as relevant as possible to the position.

Your opening paragraph should also show the hiring manager a bit about why you want this specific job. For example, mention how the job relates to your plans for the future or how it can help you grow professionally. This will show the hiring manager that you’re not just applying left and right—you’re actually enthusiastic about getting this particular role.

Now, let’s make our previous example shine:

Dear Mr. Smith,

My name’s Michael, and I’d like to help XYZ Inc. hit and exceed its sales goals as a Sales Manager. I’ve worked as a Sales Representative with Company X, another fin-tech company , for 3+ years, where I generated an average of $30,000+ in sales per month and beat the KPIs by around 40%. I believe that my previous industry experience, passion for finance , and excellence in sales make me the right candidate for the job.

The second candidate starts with what they can do for the company in the future and immediately lists an impressive and relevant achievement. Since they’re experienced in the same industry and interested in finance, the hiring manager can see they’re not just a random applicant.

From this introduction, it’s safe to say that the hiring manager would read the rest of this candidate’s cover letter.

#5. Use the Cover Letter Body for Details

The next part of your cover letter is where you can go into detail about what sets you apart as a qualified candidate for the job.

The main thing you need to remember here is that you shouldn’t make it all about yourself . Your cover letter is supposed to show the hiring manager how you relate to the job and the company you’re applying to.

No matter how cool you make yourself sound in your cover letter, if you don’t tailor it to match what the hiring manager is looking for, you’re not getting an interview.

To get this right, use the job ad as a reference when writing your cover letter. Make sure to highlight skills and achievements that match the job requirements, and you’re good to go.

Since this part of your cover letter is by far the longest, you should split it into at least two paragraphs.

Here’s what each paragraph should cover:

Explain Why You’re the Perfect Candidate for the Role

Before you can show the hiring manager that you’re exactly what they’ve been looking for, you need to know what it is they’re looking for.

Start by doing a bit of research. Learn what the most important skills and responsibilities of the role are according to the job ad, and focus on any relevant experience you have that matches them.

For example, if you’re applying for the position of a Facebook Advertiser. The top requirements on the job ad are:

• Experience managing a Facebook ad budget of $10,000+ / month
• Some skills in advertising on other platforms (Google Search + Twitter)
• Excellent copywriting skills

So, in the body of your cover letter, you need to show how you meet these requirements. Here’s an example of what that can look like:

In my previous role as a Facebook Marketing Expert at XYZ Inc. I handled customer acquisition through ads, managing a monthly Facebook ad budget of $40,000+ . As the sole digital marketer at the company, I managed the ad creation and management process end-to-end. I created the ad copy and images, picked the targeting, ran optimization trials, and so on.

Other than Facebook advertising, I’ve also delved into other online PPC channels, including:

• Google Search

Our example addresses all the necessary requirements and shows off the candidate’s relevant skills.

Are you a student applying for your first internship? Learn how to write an internship cover letter with our dedicated guide.

Explain Why You’re a Good Fit for the Company

As skilled and experienced as you may be, that’s not all the hiring manager is looking for.

They also want someone who’s a good fit for their company and who actually wants to work there.

Employees who don’t fit in with the company culture are likely to quit sooner or later. This ends up costing the company a ton of money, up to 50% of the employee’s annual salary , so hiring managers vet candidates very carefully to avoid this scenario.

So, you have to convince the hiring manager that you’re passionate about working with them.

Start by doing some research about the company. You want to know things like:

• What’s the company’s business model?
• What’s the company’s product or service? Have you used it?
• What’s the company’s culture like?

Chances are, you’ll find all the information you need either on the company website or on job-search websites like Jobscan or Glassdoor.

Then, pick your favorite thing about the company and talk about it in your cover letter.

But don’t just describe the company in its own words just to flatter them. Be super specific—the hiring manager can see through any fluff.

For example, if you’re passionate about their product and you like the company’s culture of innovation and independent work model, you can write something like:

I’ve personally used the XYZ Smartphone, and I believe that it’s the most innovative tech I’ve used in years. The features, such as Made-Up-Feature #1 and Made-Up-Feature #2, were real game changers for the device.

I really admire how Company XYZ strives for excellence in all its product lines, creating market-leading tech. As someone who thrives in a self-driven environment, I truly believe that I’ll be a great match for your Product Design team.

So, make sure to do your fair share of research and come up with good reasons why you're applying to that specific company.

Is the company you want to work for not hiring at the moment? Check out our guide to writing a letter of interest .

#6. Wrap It Up and Sign It

Finally, it’s time to conclude your cover letter.

In the final paragraph, you want to:

• Wrap up any points you couldn't make in the previous paragraphs. Do you have anything left to say? If there’s any other information that could help the hiring manager make their decision, mention it here. If not, just recap your key selling points so far, such as key skills and expertise.
• Express gratitude. Politely thanking the hiring manager for their time is always a good idea.
• Finish the cover letter with a call to action. The very last sentence in your cover letter should be a call to action. This means you should ask the hiring manager to do something, like call you and discuss your application or arrange an interview.
• Remember to sign your cover letter. Just add a formal closing line and sign your name at the bottom.

Here’s an example of how to end your cover letter :

I hope to help Company X make the most of their Facebook marketing initiatives. I'd love to further discuss how my previous success at XYZ Inc. can help you achieve your Facebook marketing goals. Please don’t hesitate to reach out to me at the provided email address or phone number so that we may arrange an interview.

Thank you for your consideration,

Alice Richards

Feel free to use one of these other popular closing lines for your cover letter:

• Best Regards,
• Kind Regards,

Cover Letter Writing Checklist

Once you’re done with your cover letter, it’s time to check if it meets all industry requirements. 

Give our handy cover letter writing checklist a look to make sure:

Does your cover letter heading include all essential information?

• Professional Email
• Phone Number
• Relevant Links

Do you address the right person? 

• The hiring manager in the company
• Your future direct supervisor
• The company/department in general

Does your introductory paragraph grab the reader's attention?

• Did you mention some of your top achievements?
• Did you use numbers and facts to back up your experience?
• Did you convey enthusiasm for the specific role?

Do you show that you’re the right candidate for the job?

• Did you identify the core requirements for the role?
• Did you show how your experiences helped you fit the requirements perfectly?

Do you convince the hiring manager that you’re passionate about the company you’re applying to?

• Did you identify the top 3 things that you like about the company?
• Did you avoid generic reasons for explaining your interest in the company?

Did you conclude your cover letter properly?

• Did you recap your key selling points in the conclusion?
• Did you end your cover letter with a call to action?
• Did you use the right formal closing line and sign your name?

15 Cover Letter Tips

Now you’re all set to write your cover letter! 

Before you start typing, here are some cover letter tips to help take your cover letter to the next level:

• Customize Your Cover Letter for Each Job. Make sure your cover letter is tailored to the job you're applying for. This shows you're not just sending generic applications left and right, and it tells the hiring manager you’re the right person for the job.
• Showcase Your Skills. Talk about how your skills meet the company’s needs. And while your hard skills should be front and center, you shouldn’t underestimate your soft skills in your cover letter either.
• Avoid Fluff. Don’t make any generic statements you can’t back up. The hiring manager can tell when you’re just throwing words around, and it doesn’t make your cover letter look good.
• Use Specific Examples. Instead of saying you're great at something, give an actual example to back up your claim. Any data you can provide makes you sound more credible, so quantify your achievements. For example, give numbers such as percentages related to your performance and the timeframe it took to accomplish certain achievements.
• Research the Company. Always take time to learn about the company you're applying to. Make sure to mention something about them in your cover letter to show the hiring manager that you're interested.
• Follow the Application Instructions. If the job posting asks for something specific in your cover letter or requires a certain format, make sure you include it. Not following instructions can come off as unattentive or signal to the hiring manager that you’re not taking the job seriously.
• Use the Right Template and Format. Choose the right cover letter format and adapt your cover letter’s look to the industry you’re applying for. For example, if you’re aiming for a job in Law or Finance, you should go for a cleaner, more professional look. But if you’re applying for a field that values innovation, like IT or Design, you have more room for creativity.
• Express Your Enthusiasm. Let the hiring manager know why you're excited about the job. Your passion for the specific role or the field in general can be a big selling point, and show them that you’re genuinely interested, not just applying left and right.
• Address Any Gaps. If there are any employment gaps in your resume , your cover letter is a great place to mention why. Your resume doesn’t give you enough space to elaborate on an employment gap, so addressing it here can set hiring managers at ease—life happens, and employers understand.
• Avoid Quirky Emails. Your email address should be presentable. It’s hard for a hiring manager to take you seriously if your email address is “[email protected].” Just use a [email protected] format.
• Check Your Contact Information. Typos in your email address or phone number can mean a missed opportunity. Double-check these before sending your application.
• Mention if You Want to Relocate. If you’re looking for a job that lets you move somewhere else, specify this in your cover letter.
• Keep It Brief. You want to keep your cover letter short and sweet. Hiring managers don’t have time to read a novel, so if you go over one page, they simply won’t read it at all.
• Use a Professional Tone. Even though a conversational tone isn’t a bad thing, remember that it's still a formal document. Show professionalism in your cover letter by keeping slang, jargon, and emojis out of it.
• Proofread Carefully. Typos and grammar mistakes are a huge deal-breaker. Use a tool like Grammarly or QuillBot to double-check your spelling and grammar, or even get a friend to check it for you.

15+ Cover Letter Examples

Need some inspiration? Check out some perfect cover letter examples for different experience levels and various professions.

5+ Cover Letter Examples by Experience

#1. college student cover letter example.

Check out our full guide to writing a college student cover letter here.

#2. Middle Management Cover Letter Example

Check out our full guide to writing a project manager cover letter here.

#3. Team Leader Cover Letter Example

Check out our full guide to writing a team leader cover letter here.

#4. Career Change Cover Letter Example

Check out our full guide to a career change resume and cover letter here.

#5. Management Cover Letter Example

Check out our full guide to writing a management cover letter here.

#6. Senior Executive Cover Letter Example

Check out our full guide to writing an executive resume here.

9+ Cover Letter Examples by Profession

#1. it cover letter example.

Check out our full guide to writing an IT cover letter here.

#2. Consultant Cover Letter Example

Check out our full guide to writing a consultant cover letter here.

#3. Human Resources Cover Letter

Check out our full guide to writing a human resources cover letter here.

#4. Business Cover Letter Example

Check out our full guide to writing a business cover letter here.

#5. Sales Cover Letter Example

Check out our full guide to writing a sales cover letter here.

#6. Social Worker Cover Letter

Check out our full guide to writing a social worker cover letter here.

#7. Lawyer Cover Letter

Check out our full guide to writing a lawyer cover letter here.

#8. Administrative Assistant Cover Letter

Check out our full guide to writing an administrative assistant cover letter here.

#9. Engineering Cover Letter Example

Check out our full guide to writing an engineer cover letter here.

#10. Receptionist Cover Letter Example

Check out our full guide to writing a receptionist cover letter here.

Need more inspiration? Check out these cover letter examples to learn what makes them stand out.

Plug & Play Cover Letter Template

Not sure how to start your cover letter? Don’t worry!

Just copy and paste our free cover letter template into the cover letter builder, and swap out the blanks for your details.

[Your Full Name]

[Your Profession]

[Your Phone Number]

[Your Email Address]

[Your Location]

[Your LinkedIn Profile URL (optional)]

[Your Personal Website URL (optional)]

[Recipient's Name, e.g., Jane Doe],

[Recipient's Position, e.g., Hiring Manager]

[Company Name, e.g., ABC Corporation]

[Company Address]

[City, State/Country]

Dear [Recipient's Name],

As a seasoned [Your Profession] with [Number of Years of Experience] years of industry experience, I am eager to express my interest in the [Job Title] position at [Company Name]. With my experience in [Your Industry/Sector] and the successes I've achieved throughout my education and career, I believe I can bring unique value and creativity to your team.

In my current role as [Your Current Job Title], I've taken the lead on more than [Number of Projects/Assignments] projects, some valued up to $[Highest Project Value]. I pride myself on consistently exceeding client expectations and have successfully [Mention a Key Achievement] in just a [Amount of Time] through [Skill] and [Skill].

I've collaborated with various professionals, such as [List Roles], ensuring that all [projects/tasks] meet [relevant standards or objectives]. This hands-on experience, coupled with my dedication to understanding each [client's/customer's] vision, has equipped me to navigate and deliver on complex projects.

My key strengths include:

• Improving [Achievement] by [%] over [Amount of Time] which resulted in [Quantified Result].
• Optimizing [Work Process/Responsibility] which saved [Previous Employer] [Amount of Time/Budget/Other Metric] over [Weeks/Months/Years]
• Spearheading team of [Number of People] to [Task] and achieving [Quantified Result].

Alongside this letter, I've attached my resume. My educational background, a [Your Degree] with a concentration in [Your Specialization], complements the practical skills that I'm particularly eager to share with [Company Name].

I'm excited about the possibility of contributing to [Something Notable About the Company or Its Mission]. I'd be grateful for the chance to delve deeper into how my expertise aligns with your needs.

Thank you for considering my application, and I look forward to hearing from you soon.

The Heart of Your Job Search - Creating a Killer Resume

Your cover letter is only as good as your resume. If either one is weak, your entire application falls through.

After all, your cover letter is meant to complement your resume. Imagine going through all this effort to leave an amazing first impression in your cover letter, only for the hiring manager to never read it because your resume was mediocre.

But don’t worry; we’ve got you covered here, too.

Check out our dedicated guide on how to make a resume and learn everything you need to know to land your dream job!

Just pick one of our resume templates and start writing your own job-winning resume.

Key Takeaways

Now that we’ve walked you through all the steps of writing a cover letter, let’s summarize everything we’ve learned:

• A cover letter is a 250 - 400 word document that’s meant to convince the hiring manager that you’re the best candidate for the job.
• Your job application should always include a cover letter alongside your resume.
• To grab the hiring manager’s attention, write a strong opening paragraph. Mention who you are, why you’re applying, and a standout achievement to pique their interest.
• Your cover letter should focus on why you’re the perfect candidate for the job and why you’re passionate about working in this specific company.
• Use the body of your cover letter to provide details on your skills, achievements, and qualifications, as well as make sure to convey your enthusiasm throughout your whole cover letter.
• Recap your key selling points towards the end of your cover letter, and end it with a formal closing line and your full name signed underneath.

At Novorésumé, we’re committed to helping you get the job you deserve every step of the way! 

Follow our career blog for more valuable advice, or check out some of our top guides, such as:

• How to Make a Resume in 2024 | Beginner's Guide
• How to Write a CV (Curriculum Vitae) in 2024 [31+ Examples]
• 35+ Job Interview Questions and Answers [Full List]

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What To Include In A Cover Letter (With Examples)

• Cover Letter Format
• Salutation and Greeting
• Who To Address When Unknown
• How To Start A Cover Letter
• How To End A Cover Letter
• Best Cover Letter Font And Size
• Cover Letter Spacing
• Cover Letter Length
• Key Elements Of A Cover Letter
• How To Write An Address
• Official Letter Format
• Cover Letter Opening

Find a Job You Really Want In

Cover letters are the first introduction to you as a person and potential employee. While resumes cover your work experience and skills, the cover letter explains why you, specifically, should get the job. It’s where you can showcase your writing skills, why you want the position, and highlight your relevant skills and qualifications. If you’re looking to write up a cover letter for a job you’re applying to, or if you want to see if your letter checks all the boxes, then this article will help you out. While a hiring manager may not select you entirely because of your cover letter, giving it that extra bit of shine could push you into the top candidate slot. Key Takeaways Your cover letter should include: Your contact information and the date The employer’s contact information A greeting Body paragraphs A closing paragraph A sign-off You should customize your cover letter to every position you apply to. Focus on what you can add to the company in your cover letter. Work keywords from the job description into your cover letter. In This Article    Skip to section What to include in a cover letter Example cover letter Cover letter tips What not to put in a cover letter Final thoughts Cover letter FAQ References Sign Up For More Advice and Jobs Show More What to include in a cover letter

Cover letters, like every business communication, have a set of rules that you’re expected to follow. They should be short, confident, and include information relevant to the job. The format of a cover letter determines what goes where, meaning that you won’t have to spend long organizing your letter.

With that in mind, here’s everything you need to include in each part of your cover letter :

Your Contact Information and the Date

The very first key element your cover letter is going to be a header that includes your contact information. You’re going to list your name, your address, your phone number, and your email address. Feel free to include your LinkedIn contact information or a link to your online portfolio .

Make sure you create a professional email address if you don’t already have one. Something like [email protected]. It’s another way to make a good first impression on the hiring manager.

Lulu Paige 333 First Street Los Angeles, CA , 90001 (000) 111-2222 [email protected] January 1, 2023

Employer’s Contact Information

Even though most cover letters are submitted online nowadays, it’s still a rule of thumb to include the company’s contact information. Google the company to find their local address and list it beneath your own contact information.

If you can’t find out the company’s local address, don’t sweat it — but if you can find it, include it just for tradition’s sake.

Adam Smith Recruiter TopNotch Company 111 West Street Los Angeles, CA 90001

How you address your cover letter is more important than you might think. Try to avoid greetings like “ To Whom It May Concern ” or “ Dear Sir or Madam. ” While there’s nothing inherently wrong with either, they’re seen as out of date and impersonal.

Hiring managers value it if you show you’re willing to put in the extra effort to find out who to address the letter to. Put effort into finding out the name of the person who’s going to be reading your cover letter. Call the company’s front office or review their website to find their hiring manager’s name.

Acceptable addresses include:

Dear Chris Rogers, Dear Mr. Rogers, Dear Mr. Chris Rogers, Dear Hiring Manager, Dear Human Resources Manager,

While conventional wisdom states that using the person’s title (in this case “Mr.”) is preferable and more polite, be very careful about assuming someone’s gender. If their honorific is Dr., then it’s safe to include, but unless you know what the hiring manager’s preferred pronouns are, it’s best to just use their full name.

Body Paragraphs

The body of your cover letter is the most important part. It tells the employer what job you’re applying for, why they should bring you in for an interview , and how you’re going to follow up.

First paragraph. This is your cover letter introduction . It’s where you’re going to grab the employer’s attention and make them want to read the rest of your cover letter.

Let’s not waste any time in this paragraph — go ahead and tell them which position you’re applying for and how it relates to your background, and show them that you’re excited about the opportunity.

I am interested in applying for your Social Media Manager position that I saw advertised on Zippia .com. After contributing to the growth and success of my last employer’s presence on Facebook and Instagram, I am seeking new challenges with a company that is looking for someone with exceptional leadership and management abilities.

Second paragraph. This is where you’re going to tell the hiring manager what you have to offer. Use this paragraph to list your qualifications, give examples from your work experience , and quantify any of your achieved results.

I know my proven leadership skills, strong commitment to growing a social media base, and flexibility with regard to assignments would allow me to make a significant contribution to TopNotch Company. I welcome the opportunity to discuss how my qualifications could benefit your company’s continued success.

Pro tip: Go into more depth on your relevant qualifications, but make sure not to copy your resume word for word. Use your cover letter to highlight the most important reasons why you’re the ideal candidate.

Third paragraph. Discuss what you know (and like) about the company. This is your chance to impress the employers even further by showing them that you care enough to do some background research on the company , and how you can contribute to their mission.

TopNotch’s commitment to a sustainable future aligns with and inspires my own values of environmental consciousness and stewardship. Even as a digital marketer , I found ways to reduce my office’s carbon emissions by 11%, and I’d be thrilled to work for a company that values and prioritizes such changes.

Feel free to mention any current events, information about the company’s history, their core values, or their mission statement.

Closing Line

The final paragraph is where you’re going to close your cover letter . Summarize what you could bring to the position and request an interview or a phone call.

I’d like to thank you again for taking the time to review my application and resume, and I welcome the opportunity to discuss my qualifications with you in detail.

Picking an appropriate and successful sign-off is trickier than you might think. A cover letter is a professional document, so you have to be strategic with everything you write.

With that in mind, here are some sign-offs to choose from that hiring managers respond well to:

Best regards

Respectfully

Thanks in advance

And here are some sign-offs you should avoid at all costs:

Best wishes

Affectionately

Sent from my iPhone

You get the idea. Pick an appropriate sign-off, sign your name, and then you’ve got yourself a cover letter!

Example cover letter

Lulu Paige 333 First Street Los Angeles, CA, 90001 (000) 111-2222 [email protected] January 1, 2020 Adam Smith Recruiter TopNotch Company 111 West Street Los Angeles, CA 90001 Dear Mr. Smith, I am interested in applying for your Social Media Manager position that I saw advertised on Zippia.com. After contributing to the growth and success of my last employer’s presence on Facebook and Instagram, I am seeking new challenges with a company that is looking for someone with exceptional leadership and management abilities. As you will see in my enclosed resume, while serving as a Social Media Intern, I was tasked with onboarding new employees and managing their publishing schedules as well as coming up with content for my own calendar. My ability to juggle these different tasks reinforced my desire to advance in my career and step into a management role. I know my proven leadership skills, strong commitment to growing a social media base, and flexibility with regard to assignments would allow me to make a significant contribution to TopNotch Company. I welcome the opportunity to discuss how my qualifications could benefit your company’s continued success. I’d like to thank you again for taking the time to review my application and resume, and I welcome the opportunity to discuss my qualifications with you in detail. Sincerely, Lulu Paige

Cover letter tips

Knowing all the parts of a cover letter is essential, but that’s not the only trick to writing an excellent cover letter. Putting in a bit of extra effort will make your cover letter stand out from the rest, and will therefore make you more likely to get an interview.

Customize each cover letter. When you’re sending out applications to multiple companies, it’s essential to tailor each cover letter and resume for the job. Your resume customization may just take a few strategic keyword changes and emphasizing different parts of your experience.

Your cover letter customization, however, should be much more thorough. Hiring managers and recruiters can spot a generic cover letter a mile away, so be sure to talk specifically about why you’re interested in the company and what particular value you’d have for the company.

Find the hiring manager. In the spirit of customization, try your best to find the hiring manager or recipient’s name. Review the job posting for contact info, research the company’s website, and look on LinkedIn if you’re stuck. Or just call the company’s HR department and ask.

If you’re still stuck, “Dear Hiring Manager” or one of its alternatives will work.

Don’t copy your resume. Instead of repeating every point from your resume, pick one or two bullet points to really emphasize. Think about what accomplishments you can quantify since those are the most compelling evidence of your past success.

Also, your cover letter should answer the “how” and “why” of your career, so discuss how you achieved those awesome results and why you enjoy doing things your way.

Always focus on the company. A cover letter is your chance to sell yourself, but that mostly means highlighting how the company will benefit from your skills , methodologies, and contributions.

Steal keywords from the job description. Highlight keywords from the job description like skills, qualifications, and attributes, and then incorporate some of those words throughout your resume and cover letter. That way, it’s super easy for a recruiter or hiring manager to see how your experience matches up with the job requirements.

Match the company culture. Spend some time researching the company on their website and scouting employees on LinkedIn. If you can match the tone of the company’s written communications, you’ll be in good shape for presenting as a solid cultural fit.

Let your personality shine. Resumes are boring, but cover letters are your chance to showcase who you are as a person as well as a professional. Don’t go overly formal (unless you’re applying to a conservative firm).

Hiring managers want to know what kind of person you’re like to work with, and while the interview will inform them more fully, your cover letter is meant to whet the reader’s appetite so they want to call you in for an interview in the first place.

Open and finish strong. Cover letters are generally skimmed, so you really want to make your opening and closing lines count. Open with an attention grabber and finish with a strong call-to-action and reminder of your awesomeness and enthusiasm.

Keep it short . Cover letters should never be more than 400 words, but we recommend aiming for a 200-300 word count. As we said, recruiters usually skim these things, so make it easy for them.

Review and edit. Never send a cover letter without a proofread, a spellcheck program, and, if possible, a trusted confidant to read it over. Another pair of eyes might catch things you didn’t notice re-reading it over and over again.

Email cover letters. If you’re emailing your cover letter directly (as opposed to attaching it or mailing it physically), be sure to include a descriptive subject line.

Often, employers will tell you how to label your email in the job posting, so follow any directions there. If not, a subject line that includes your name and the position you’re applying for is a safe bet.

For an email cover letter, don’t include contact information at the start. Instead, put your contact information after your signature (you can skip your physical address) and leave out the company’s contact information entirely.

What not to put in a cover letter

Knowing what to avoid putting in your cover letter can be just as helpful as knowing what to put in it. Here are a few items you should leave out:

Lies (even little white ones or stretched truths).

Anything about salary.

Negativity about your current job.

Information about your personal life.

Long-winded paragraphs.

Unneccessary or irrelevant information.

Grammatical errors.

Misspelled words (including names).

Unprofessional email addresses or file names.

Polarizing or controversial hobbies or opinions.

Final thoughts

Cover letters are one of your most valuable tools when it comes to applying for jobs. They let you go into detail about your qualifications, demonstrate your communication skills , and show that you’re interested in a specific company.

When you write your cover letter, make sure to include your professional contact information, go into detail about your relevant skills, and show that you’re motivated to help the company achieve its goals. Show the hiring manager why you’re the best person for the position, and you’re on your way to getting the job of your dreams .

Cover letter FAQ

Do you need a cover letter?

Whether or not you need a cover letter will depend on the application’s requirements, but they’re highly recommended. Unless the instructions explicitly state not to send in a cover letter, it’s recommended to include one.

Cover letters allow you to focus on skills relevant to the job that may not fit into your resume. It also lets you show that you’ve looked into the company by mentioning something about its culture, knowing the hiring manager’s name, or mentioning key skills.

What should you include in a cover letter?

A cover letter should include:

Your contact information. Include your name, address, phone number, and email address.

Company’s contact information. This should include the name of the company, their phone number, email address, and physical address if you can find it.

Salutation. Do your best to address this directly to the hiring manager that will be reviewing your application.

Introduction. This is the part where you say who you are and why you’re applying.

Body. This should be one to two paragraphs that cover your relevant skills, why you think you’d be a good fit for the job, and show your interest.

Closing line. Make sure to thank the hiring manager for their time. It’s also recommended to include a call to action, such as saying “I look forward to hearing from you.”

Sign off. Make sure to end with a professional closing, such as “Sincerely,” and then your full name.

How do you format a cover letter?


Cover letters should be formatted in standard business format. That means that it should use a 10 or 12-point legible font, such as Times New Roman, have double spacing between paragraphs, and be no longer than a page .

Harvard Business Review — How to Write a Cover Letter

National Careers Service — How to Write a Cover Letter

University of Wisconsin-Madison — Writing Cover Letters

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Maddie Lloyd was a writer for the Zippia Advice blog focused on researching tips for interview, resume, and cover letter preparation. She's currently a graduate student at North Carolina State University's department of English concentrating in Film and Media Studies.

Matt Warzel a President of a resume writing firm (MJW Careers, LLC) with 15+ years of recruitment, outplacement, career coaching and resume writing experience. Matt is also a Certified Professional Resume Writer (CPRW) and Certified Internet Recruiter (CIR) with a Bachelor of Science in Business Administration (Marketing Focus) from John Carroll University.

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What to Include in the Body Section of a Cover Letter

What Is the Body of a Cover Letter?

What to include in each paragraph, first paragraph, middle paragraphs, final paragraph, what else to include in your letter, include keywords.

• Write a Custom Cover Letter
• When You're Emailing a Cover Letter

Short and Sweet is Fine

Aim for natural language, proofread and proofread again.

Writing cover letters is no one’s favorite part of the job search process, and the body of the letter is the hardest part. This is where you try to capture the hiring manager’s attention and emphasize your unique qualifications for the job, without repeating the same exact information you’ve included on your resume.

The body of your cover letter is the section which tells the hiring manager what position you're applying for and why the employer should select you for an interview. You're selling your candidacy to the reader, so it's important to be specific about your qualifications as they relate to the position.

The body of your cover letter should include an explanation of why you're interested in and qualified for the job for which you're applying. These persuasive paragraphs are intended to convince the reader that you're the perfect person for the position.

A successful cover letter will win you an interview, so it's important to be compelling and show the hiring manager that you're a strong candidate. The hiring manager will spend seconds reviewing your letter or email message , which means you don't have much time to connect with the employer and make a positive impact.

The first paragraph of your letter should include information on why you're writing. Mention the position you're applying for and where you saw the listing. Include the name of a contact or reference, if you have one.

The next section of your cover letter should describe what you have to offer the employer. Make strong connections between your qualifications and the position requirements. Mention specifically how your skills and experience match the job you're applying for. Use several shorter paragraphs or a bulleted list of your qualifications rather than one large block of text. This will make it easy for the reader to quickly scan and absorb this important information.

Conclude your cover letter by thanking the employer for considering you for the position. Include information on how you will follow up if you have the contact information for the hiring manager to do so.

The rest of letter is important, too. You will need to include your contact information, which is listed at the top of a written letter or below your signature in an email cover letter.

Your letter also needs to include a professional greeting, a professional closing, and your signature. You will sign your name on a printed cover letter. If you upload or email your cover letter, your signature will be your typed name.

This is especially important if you’re submitting your cover letter and resume to an online listing. To get past the applicant tracking system and to a real human being, your cover letter will need to contain the right keywords. To find these, scan the job listing for keywords related to the skills and qualifications required.

Write a Custom Cover Letter Every Time

It’s fine to begin with a cover letter template , but you’ll want to customize your cover letter to each role. Include details like how you found out about the job, why you’re particularly interested in the role, and why your experience, skills, and qualifications make you the perfect candidate.

Here is an example of a cover letter. Download the cover letter template (compatible with Google Docs and Word Online) or see below for more examples.

Custom Cover Letter Sample (Text Version)

Jasmine Applicant  123 Main Street  Anytown, CA 12345  555-555-5555  jasmine.applicant@email.com

September 1, 2018

Michael Lee  Director, Human Resources  Calico Corner  123 Business Rd.  Business City, NY 54321

Dear Mr. Lee,

I am writing to apply for the store manager training program as posted on the careers page of Calico Corner’s website. I was excited to see this opening because I enjoy shopping at your stores and I have experience in retail management.

After reading the requirements, I believe I would be an excellent fit for the management position. I’ve spent the past three years as an assistant manager of a small convenience store, while finishing my bachelor’s degree. This job has given me the opportunity to manage employees as well as work with the general public. In addition, I have a background in textiles and recently graduated with a Bachelor of Fine Arts from Western State University, with a minor in business and marketing. 

I’ve included my resume so you may review my education and work experience in addition to the skills I’ve gained, such as customer service, employee management, communication, social media marketing, and design.

If you have any questions or wish to know more about my qualifications, please do not hesitate to contact me. My cell phone number is 555-555-5555 and my email is jasmine.applicant@email.com.

I look forward to hearing from you about this exciting position.

Jasmine Applicant

When You're Emailing a Cover Letter

If you're emailing a cover letter , list your contact information after your typed name instead of at the top of the letter.

Don’t feel the need to go on and on. Three well-written paragraphs that highlight your experience and make your case are better than a lengthy letter that no one will read.

While resumes are necessarily a bit more to the point, you’re trying to woo the hiring manager, and that means letting your natural charm and enthusiasm shine through. Think about what would make you sit up and take notice if you were reading this cover letter. What would inspire you to call you in for an interview?

It can never be said enough, have a trusted friend proofread your cover letter before you send it along. Even professional editors miss mistakes in their own writing. Get a second set of eyeballs on your cover letter before you hit send or upload. 

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Types of cover letters: a complete guide

A cover letter introduces you to potential employers, highlighting your suitability for the role. Getting it right can make a strong first impression, differentiate you from other candidates, and increase your chances of securing an interview.

Taralika crafts compelling narratives that illuminate modern hiring practices and HR technology trends.

A cover letter accompanies a candidate’s resume when applying for a job. It is a personal introduction to the hiring manager, highlighting relevant skills, experiences, and reasons for applying.

Unlike a resume, which provides a structured overview of the career history, a cover letter offers a narrative that can showcase a candidate’s personality and passion for the role. 

74% of recruitment decision-makers prefer to receive job applications that include cover letters apart from CVs. According to their findings, good cover letter examples are highly valued by employers, with many considering them crucial for explaining career objectives, motivations, and employment gaps.

Even if a cover letter is optional, over 75% of recruiters tend to give preference to candidates who attach a cover letter in the correct format along with their resume.

Types of cover letters

Before writing a cover letter, it is vital to go through the various types of cover letters accepted by different organizations, each catering to a different role or purpose: – 

• Application cover letter

The application cover letter responds to a specific job posting. It should be a basic cover letter tailored to the job description, highlighting how the candidate’s qualifications match the requirements. Using this letter can expand on the achievements listed in the resume and explain the person’s motivation for applying. 

• Prospecting cover letter

Also known as a cold-contact letter, a prospecting cover letter is used when you want to inquire about potential job openings at a company. This type of letter demonstrates a proactive approach and interest in the organization, even if there are no current vacancies. 

• Networking cover letter 

A networking cover letter is sent to contacts within the professional network to ask for job search advice or referrals. It’s a great way to leverage connections and uncover hidden job opportunities. The letter should mention the mutual contact and explain the candidate’s job search goals.

• Career change cover letter

If an individual is transitioning into a new career, a career change cover letter is perfect for them! It is a short cover letter highlighting examples from experiences in the current role and how they make a suitable candidate for the new role. This letter should also explain the reasons for the career shift and highlight any transferable skills.

• Referral cover letter

When someone within an organization refers a colleague for a position, it is generally in the form of a referral cover letter. Mentioning the referrer in your letter can immediately capture the hiring manager’s attention and add credibility to your application. 

• No experience cover letter 

A no experience cover letter is for those who lack direct work experience in the job they are applying for. An ideal no experience cover letter will contain examples emphasizing the candidate’s enthusiasm, willingness to learn, and any relevant skills or coursework that can compensate for the lack of professional experience.

Cover letter examples 

Checking out a few good cover letter examples is a great way to get a head start towards crafting the perfect cover letter. 

Also read: Top 3 Cover Letter Template Samples .

The cover letter examples for a job provide a clear understanding of how to format and phrase cover letters for different scenarios.

Tips for writing a good cover letter

According to the Business and Professional Communication Quarterly , 56% of employers prefer cover letters with job applications. Here are some useful tips on how to type a cover letter that will help you stand out amongst others:

Customize each letter

Statutory warning – generic cover letters are easily spotted and often disregarded! Tailor the cover letter to the specific job and company. While it may be cool to generate cover letter formats through an AI tool, it is crucial to personalize and write the main content of the cover letter. 

Use a professional format

Follow a standard cover letter format with your contact information, the employer’s contact details, a salutation, body paragraphs, and a closing. 

Be concise and focused

Keep your letter to one page and avoid unnecessary details. Stick to relevant points that highlight your suitability for the job. Workable has a list of short cover letter examples that you can check out here . 

Showcase your achievements

Unlike a resume, a cover letter has examples from a person’s real life, showcasing key abilities and accomplishments and how they’re suitable for the job. 

Also read : Rise above the crowds: how to stand out in a crowded market

Include a strong introduction

Your cover letter introduction should grab the reader’s attention and make them want to learn more about you. 

Proofread thoroughly

Ensure no grammatical or spelling errors. A clean error-free letter shows your attention to detail and professionalism.

A well-written cover letter can significantly boost a candidate’s chances of landing a job interview. 

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Key Elements of a Cover Letter

The cover letter is usually the first item an employer reads from you. Your letter should immediately indicate what position you are applying for and then give information that demonstrates why you should be considered for the position. Do not repeat all of the information contained in your resume. Instead, highlight or elaborate on resume items that are directly applicable to the position for which you are applying. The following information should be included in your cover letter.

Information about you

Begin your cover letter with your contact information. It should be in block style, on the left margin of your paper, towards the top. Name Current home address Telephone number

Include a date as you would do with any business letter.

Contact Person's Name, Title, Employer, and Address

Including a specific name can get your letter and resume to the hiring manager more quickly and can be an effective personal touch. If you are applying for an advertised position that does not give a name to contact, call the company and ask for the department manager's name.

Choose the appropriate way to address the contact person. For example: Dear Mr. Johns (if a man's name is the contact) Dear Ms. Smith (if a woman's name is the contact) Dear Prospective Employer (if there is no contact name)  

Opening Paragraph

In the opening paragraph tell how you learned about the position. You may, for example, know of a job through: a classified advertisement an unsolicited mailing the Internet personal referrals

Middle Paragraph

This paragraph gives a summary of your background and critical skills (hard skills) that make you qualified for the position.

Second Middle Paragraph

This paragraph can be used to demonstrate your persuasive skills (soft skills).

Contact Information and Closing

At the end of the letter talk about your availability for the job, where you can be contacted, and when you are going to contact the hiring person for an appointment to discuss your application. If you have no contact name you may simply want to indicate your anticipation for a response in this part of the letter. Thank the person to whom you are writing for his/her time and consideration of your application.

Other Considerations:

Paper and Printing

• Use white or ivory (20-25 lb.), 8 ½ x 11 bond paper printed on one side only.
• Use the same paper for resume, cover letter, and envelopes if possible.
• Make sure that there is no shadowing or dirty marks from your printer on the papers.

Error Prevention

• Follow instructions in employment ads or recruitment directions.
• Proofread! Look for spelling and formatting errors. Make sure recipient's name, company name, and title are correctly spelled in the letter and on the envelope.
• Proofread again!
• Have another person proofread your letter and resume.
• Be sure there are no errors of fact.
• Sign in blue or black ink.
• Keep a copy of the cover letter and resume for your records.
• Follow up with a phone call, about five days after expected delivery.

Layout and Design

• Follow standard cover letter format.
• Keep the cover letter to one page.
• Set margins at 1 ½”.
• Use a simple, easy to read font style, 10-14 point. (Times, Courier, or Helvetica)
• Use boldface, italics, all-caps and underlining, but don't overdo it.

Planning and Tone

• Tailor each cover letter to one specific position.
• Use industry jargon specific to your career field.
• Identify the employer's key words and use them.
• Make all statements positive. Check the tone by asking yourself if each sentence leaves a positive impression.
• Show originality but not cuteness.
• Use action verbs and phrases .
• Sound determined and confident not desperate.
• Organize context in a reasonable and logical order.
• Use correct grammar.
• Keep sentences short.
• Keep paragraphs short.
• Use short words and simple language.
• Make every word count.
• Punctuate using commas, dashes, and periods.
• Focus on the employer's need for a worker, rather than your need for a job.
• Tell how your skills and personal qualities match the employer's needs.
• Focus on what you can do for the employer and how you contribute to the organization.
• Show you have researched the company double check those facts.
• Be specific avoid general statements.

What’s the purpose of a cover letter?

Your resumé provides hiring managers with an overview of your qualifications, skills and experience. But what is the purpose of a cover letter?

A cover letter is a more personalised introduction, a one-page document that accompanies your resumé when you submit a job application. It’s an opportunity to introduce yourself and elaborate on how your background makes you the ideal applicant for the role.

In this article, we explore the purpose of a cover letter, explain how to write a cover letter , and how to ensure yours stands out.

The cover letter’s purpose

How to write a cover letter.

What is the purpose of a cover letter? A cover letter provides an explanation of your professional history, qualifications and interest in the position. It should be closely tailored to the role you’re applying for and addressed to the hiring manager . It’s a formal introduction of who you are and how you meet the job criteria.

Express your enthusiasm

Use your cover letter as an opportunity to set yourself apart from the other job seekers applying for the same position. Rather than just stating that you’re applying for a role, take your time to explain what excites you about the specific position and company.

It can be a good idea to spend a bit of time researching the organisation’s mission, values and recent projects to demonstrate genuine interest and knowledge. This can also come in handy for the interview round of the application process.

Showcase your skills and experience

Your cover letter shouldn’t just repeat your resumé. Instead, select two to three skills or experiences directly related to the job description. From here, you can use the STAR method (situation, task, action, result) to provide examples demonstrating how you’ve applied these skills and achieved results. Consider quantifying your achievements, if relevant, for example: ‘Increased sales over three months by 20%.’ This helps to illustrate the specific value you can bring to the new role.

Tell your story

Use your cover letter to briefly explain your career path and motivations, connecting them to the position you're applying for. Highlight the relevant soft skills that you might not have captured in your resumé, like leadership, teamwork, problem solving and decision-making. While a cover letter is a great opportunity to provide a little more depth and context around your resumé, it’s important to keep it concise; around three short paragraphs.

Address requirements from the job description

Whether you’re writing your resumé or your cover letter, it’s important to pay close attention to the job description. If it mentions specific details to include, like salary expectations or relevant certifications, be sure to address them in your cover letter. Following instructions demonstrates your attention to detail and ability to follow directions, which are both important qualities for any employer.

When it comes to writing a cover letter , it always helps to have a plan. Here are a few steps to help you turn a blank page into an attention-grabbing cover letter for your next job application.

1. Do your research

Researching the company can take a bit of time, especially if you’re applying at several different places, but it’s essential to understand each company’s culture and values. Using company-specific information allows you to personalise your cover letter to suit not just the role, but the organisation too.

It’s even better if you can show an understanding of the problems the company is trying to solve (their main objectives, like expanding into a new market or getting highly skilled labourers). Highlight the experience you bring to the table to help them overcome these pain points.

2. Focus on the future

Use your cover letter to demonstrate how you can contribute to the company’s future successes. It can help to line up your career aspirations and professional goals with the company’s goals. Ultimately, you want to highlight what you can add to the company.

How to stand out from other applicants

Use your cover letter as an opportunity to set yourself apart from the other applicants. Avoid generic openings and start with a compelling introduction that grabs the reader’s attention. You could mention a specific achievement, a mutual connection or something unique about the company that excites you.

Here are a couple of examples of eye-catching email subject lines and letter introductions:

Subject line: Bringing [specific skill] to your [position] team

Dear [hiring manager’s name],

I am thrilled to apply for the maintenance plumber position at XYZ Corp. With 10 years of experience as a commercial plumber, I am excited about the opportunity to bring my skills and knowledge to your team.

Subject line: Excited to apply for [position] at [company]

As a lifelong admirer of XYZ Corp’s commitment to sustainability, I am excited to apply for the environmental consultant position. I believe my recent project at Green Earth, where I led a team to reduce product carbon emissions by 15%, makes me a perfect addition to your team.

These are good examples of email introductions, because they:

• Connect your abilities to the job ad criteria
• Quantify related achievements
• Show specific skills
• Display professionalism and research skills

Things to avoid

There are also some things you may want to avoid when putting together your cover letter introduction. Here are some examples of what not to write when it comes to your email subject line and introduction.

Example 1: Being vague and generic

Subject line: Excited to apply for the banking consultant position

I am writing to apply for the consultant position as advertised online. I have more than five years’ experience across all areas of commercial banking and believe I could be an excellent addition to your team.

This is an okay introduction, but there are ways it can be improved:

• It should be addressed to a person or the hiring manager
• It can be more specific about past experience
• It should mention the hiring company
• It could include a quantifiable result

Example 2: Being too casual

Subject line: Please Hire Me As You New Night Manager!

Dear Hiring Manager,

I’m an experienced night manager, with nearly two years of experience in luxury five-star hospitality. I’m an international student with a current work visa for working in Australia, and would be grateful if you could consider my application. I am sure I can do well in your company!

There are a few issues with this intro:

• There is a typo in the subject line
• It is too generic about past experience
• It is too casual, especially for a manager-level role
• It doesn’t mention the hiring company
• It should be more concise, i.e. not repetitive or wordy

Emphasise your value proposition

Use your cover letter to identify and articulate your unique strengths . Be sure to connect your skills with the company’s needs to demonstrate the value you could bring to the team.

Convey enthusiasm, but ensure tone is professional

While it’s important to convey your enthusiasm for the position and company, balancing excitement with professionalism is important. For example, replace “I can’t wait to work with you guys” with “I’m eager to bring my skills to your team.” While the first example is too casual, the second example demonstrates your enthusiasm in a professional tone.

Here’s another example of an overly enthusiastic and informal tone, “I’m super excited about this job! I’ve always dreamed of working at XYZ Corp, and I know I’d be amazing in this role!”

Instead, you’d be better off saying, “I am excited to apply for the receptionist position at XYZ Corp. With my strong background in office administration and a passion for customer service excellence, I am eager to contribute to your team.”

Keep it short

Don’t go overboard with your cover letter. Even though your cover letter is meant to provide hiring managers with more information about you and what excites you about the role, it’s important to keep it concise and limit it to a single page.

To help you keep it short and sweet, focus on starting strong with an attention-grabbing introduction and tailor your content to ensure it’s specific and relevant to the role you’re applying for.

Writing a great cover letter is an essential part of the job application process. By tailoring your cover letter to the specific company and role, you’ll be able to highlight the skills, knowledge, and experience that are relevant to the position. Your cover letter plays a big role in whether you’ll get a callback for an interview, so it’s worth investing time and effort into getting it right.

What exactly is a cover letter and how is it different from a resumé?

While a resumé offers a bullet-listed overview of your skills and experience, your cover letter is like a personal pitch to the hiring manager, elaborating on your resumé and providing a little more detail to demonstrate why you’d be a good fit for the position.

Is a cover letter always mandatory when applying for a job?

Cover letters aren’t always a requirement for job applications, but it’s always a good idea to submit one. Not only can including a cover letter improve your chances of getting noticed, but it allows you to set yourself apart from the other applicants and further try to convince the hiring manager why you’re the right fit for the role.

What are the main benefits of including a cover letter with my job application?

Including a cover letter as part of your application can enhance your chances of getting noticed by potential employers. Here are some of the main benefits:

• Provides a personal introduction and good first impression
• Allows you to highlight your most relevant skills and experience for the role
• Demonstrates communication skills
• Shows initiative and effort

How long should a cover letter typically be?

A cover letter shouldn’t be any longer than a single page. Aim for around 250–400 words or three or four paragraphs. The only time you should go over a page in length for your cover letter is if the job description specifically asks for a longer letter.

Should I use a generic cover letter template for all my applications?

There’s no harm in using a cover letter template to guide your cover letter, but it’s essential that you tailor every cover letter to suit the role and company. You should be adjusting your cover letter for each role you apply for.

What kind of information should I include in a cover letter to showcase my skills and experience?

Your cover letter should include details that are most relevant to the position and company you’re applying for. Based on your research, you should be able to identify specific skills, knowledge and experience that would help the company succeed.

Is it okay to mention my salary expectations in the cover letter?

Unless the job description specifically ask that you include your salary expectations in the cover letter, it’s often better to avoid this topic so early in the recruitment process . These types of discussions are better left for the interview.

What are some common mistakes to avoid when writing a cover letter?

You want to make a positive first impression with your cover letter, so here are a few common mistakes to avoid:

• Using generic statements
• Lack of research into the company
• Repeating your resumé without adding anything new
• Being too vague and not providing specific examples
• Focusing on what you want rather than what you can provide to the company
• Ignoring the job description keywords
• Failing to proofread your cover letter before submitting it

Is a cover letter still necessary when applying for jobs online?

Yes, cover letters are still essential to the job application process for many roles. They give you a chance to stand out from the other applicants and fill in potential gaps that aren’t covered by your resumé. Not to mention, including a cover letter demonstrates your initiative and enthusiasm for the role.

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How to End a Cover Letter: 10 Closing Examples and Tips

A detailed guide on effectively ending your cover letter with closing examples, tips and best practices for a lasting impression.

Yogini Bende

Sep 10, 2024 • 6 min read

Your cover letter's closing paragraph is your last chance to make a lasting impression on potential employers. A strong ending can reinforce your enthusiasm for the position and prompt the hiring manager to take the next step in the recruitment process.

In this article, we'll explore how to craft the perfect cover letter conclusion, providing you with examples and tips to help you stand out from the competition.

Table of Contents

Cover letter closing paragraph: what to include, ways to close a cover letter (with examples), 10 cover letter ending samples from real people, 3 examples of cover letter closing paragraphs, key takeaways: how to end a cover letter, bonus tips on ending a cover letter, dos and don'ts of ending a cover letter.

An effective closing paragraph should:

• Reiterate your interest in the position
• Summarize your key qualifications
• Express gratitude for the reader's time and consideration
• Include a call to action
• End with an appropriate sign-off

Remember, your closing paragraph should be concise yet impactful, typically 2-4 sentences long.

Here are some effective ways to close your cover letter:

Express enthusiasm: "I'm excited about the opportunity to contribute to [Company Name]'s innovative projects and look forward to discussing how my skills align with your needs."

Demonstrate confidence: "I'm confident that my experience in [relevant skill] makes me an ideal candidate for this position and would welcome the chance to elaborate on my qualifications."

Show gratitude: "Thank you for considering my application. I appreciate your time and look forward to the opportunity to discuss how I can contribute to your team."

Highlight your value: "I believe my unique combination of skills in [area 1] and [area 2] would bring significant value to your organization, and I'm eager to explore this further with you."

Mention next steps: "I will follow up next week to ensure you've received my application and to discuss potential next steps. In the meantime, please don't hesitate to contact me if you need any additional information."

"I look forward to speaking with you soon about how I can contribute to [Company Name]'s success."

"Thank you for your time and consideration. I'm excited about the possibility of joining your team and helping [Company Name] achieve its goals."

"I would welcome the opportunity to discuss how my skills and experience can benefit your organization. Please feel free to contact me at your convenience."

"I'm eager to bring my passion for [industry/field] to your team and would love the chance to elaborate on my qualifications in an interview."

"I believe my background in [relevant area] aligns perfectly with what you're looking for, and I'm excited about the prospect of contributing to your innovative projects."

"Thank you for considering my application. I'm looking forward to the possibility of joining your dynamic team and helping drive [Company Name]'s continued growth."

"I'm confident that my skills and enthusiasm would make me a valuable addition to your team. I look forward to the opportunity to discuss this further."

"I appreciate your consideration and am excited about the potential to bring my unique perspective and skills to your organization."

"Thank you for your time. I'm eager to learn more about this opportunity and how I can contribute to your team's success."

"I'm excited about the possibility of joining [Company Name] and would welcome the chance to discuss how my background aligns with your needs."

For a product designer position: "I'm excited about the opportunity to bring my user-centered design approach and innovative problem-solving skills to the product design team at [Company Name]. My experience in creating intuitive interfaces that increased user engagement by 40% aligns perfectly with your mission to deliver exceptional user experiences. I'm particularly excited about your recent project [mention a specific project if possible], and I'm eager to contribute my expertise to similar initiatives. Thank you for considering my application. I look forward to the possibility of discussing how my passion for design and technical skills can help drive [Company Name]'s product success to new heights."

For a software developer role: "I'm passionate about creating efficient, user-friendly software solutions and am eager to apply my skills to the innovative projects at [Company Name]. My experience with [relevant technologies] and track record of delivering projects on time and under budget make me an ideal fit for this role. I appreciate your time and consideration and look forward to the opportunity to discuss how I can contribute to your development team."

For an entry-level position: "As a recent graduate with a strong academic background and relevant internship experience, I'm excited about the prospect of starting my career with [Company Name]. I'm a quick learner with a passion for [industry/field], and I'm eager to bring my fresh perspective and enthusiasm to your team. Thank you for considering my application. I look forward to the opportunity to discuss how I can contribute to your organization's goals."

• Reaffirm your interest in the position and company
• Highlight your most relevant qualifications
• Include a clear call to action
• Use a professional closing salutation
• Tailor your closing to the company culture
• Keep it concise and focused
• Proofread carefully to avoid errors
• Use a confident and positive tone
• Ensure your contact information is easily visible
• Do personalize your closing for each application
• Do express genuine enthusiasm for the role
• Do mention specific aspects of the company or position that interest you
• Do provide a clear next step or call to action

Don'ts:

• Don't use generic or cliché closings
• Don't be overly pushy or presumptuous
• Don't repeat information from earlier in the letter
• Don't forget to include a professional sign-off

Crafting a strong cover letter closing is crucial for leaving a lasting impression on potential employers. By following the tips and examples provided in this article, you can create a compelling conclusion that reinforces your qualifications, expresses your enthusiasm, and encourages the hiring manager to take the next step.

Remember to tailor your closing to each specific position and company, and always proofread carefully before sending your application. If you need more help with writing cover letter, you can read this guide and check 15 Short Cover Letter Examples for Designers and Developers

If you are thinking to applying for a new job, also check out some amazing job opportunities for designers and developers on Peerlist Jobs.

All the best with your job hunt!

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Initial IND Application

The initial IND submission to the FDA will provide the reviewers with the information necessary to conduct a thorough evaluation of the safety of the investigation, and its scientific merit. The submission is divided into several sections. The summaries listed in this page will provide detailed instructions to prepare a complete IND submission.

Form FDA 1571

Current version of Form FDA 1571

Form FDA 1571 Instructions

The purpose of the Form FDA 1571 is to:

• obtain agreement from the sponsor (or sponsor-investigator) to conduct research according to all appropriate FDA regulations; and
• serve as a cover sheet for all submissions to the FDA on behalf of a particular IND.

Form FDA 1571 should be completed for every submission sent to the FDA on behalf of a particular IND and should include the below:

• Contact information and mailing address of the Sponsor (or Sponsor Investigator)
• IND number, if it has been issued
• Serial number (see below)
• The name(s) of the drug/biologic and the indication being studied
• The contents of the submission
• Name and title of the individuals responsible for monitoring the study and reviewing safety data.

Form FDA 1572

Frequently Asked Questions – Statement of Investigator (Form FDA 1572)

Current version of Form FDA 1572

Form FDA 1572 Instructions

The intent of the 1572 form is two-fold. It is a signed agreement from the Investigator (i.e., Principal Investigator) that he/she will conduct the research in compliance with FDA regulations. Additionally, it collects all the clinical site and investigator information needed by the sponsor to assure the FDA that all investigators have the experience and background needed to conduct the trial. The site investigator is responsible for updating his/her 1572 form and providing it to the sponsor in a timely manner so the information can be sent to the FDA. (Although it is not a requirement for the updated 1572 to be submitted to the FDA, it is the responsibility of the sponsor to provide updated information to the FDA; therefore the 1572 is often submitted to the FDA rather than providing information in another format.)

The Form FDA 1572 is necessary to include in an initial IND submission and must be filled out when adding a new principal investigator at each site.

• Please note that a 1572 must be submitted to the FDA within 30 days of the investigator being added and when changing any site information, i.e., IRB, laboratory, or clinical site.

Additional information to be provided:

• A current CV or statement of qualifications of the principal investigator listed on the 1572. It does not need to be signed.
• Name and address of the location where the clinical investigation will be conducted, the clinical laboratories that will be used, and the IRB reviewing the study.
• To note, it is not a requirement to fill out a new 1572 when there is a Sub-Investigator change as long as this information is sent in a timely manner to the sponsor. However, the 1572 is often used for updates to have all information in an organized place.

Form FDA 3674 - Certification of Compliance

Current version of Form FDA 3674

Form FDA 3674 Instructions

The Form FDA 3674 is a document that must accompany the initial submission, and when submitting a new protocol to IND. It is a signed statement from the sponsor that they will comply with clinicaltrials.gov requirements concerning their investigation.

It is a requirement for NIH trials to be registered on clinicaltrials.gov. OPS is responsible for registering studies on clinicaltrials.gov and the study team is responsible for updating this information when primary endpoints are met. Please see FDAAA 801 Requirements at clinicaltrials.gov for more information.

Cover Letter

The cover letter is the first piece of information that the FDA sees upon receipt of an Initial IND submission. It expresses the intent of the investigator to request FDA review of the enclosed information, and briefly describes the proposed research. It is the responsibility of the sponsor to compose the cover letter.

Items to include in the cover letter:

• The cover letter should be on departmental letterhead
• Title the cover letter: "Initial Investigational New Drug Application"
• Brief explanation of the investigation (i.e., use the study title)
• Disease or condition being studied
• Name, formulation, and proposed dose of drug product.
• Contact information (phone, email, address) of the Sponsor and (recommended) a designated individual authorized to interact with the FDA on the Sponsors behalf.
• Ensure the date of the cover letter matches the date on the signed copy of Form FDA 1571.
• If the sponsor and FDA have already had a Pre-IND meeting, then this should be noted in the letter, and reference the PIND number and date of meeting.

The cover letter can be short, ~ 1-2 pages, and should be addressed to either the appropriate CDER/CBER Division Director with a copy sent to the Division's Chief of Project Management staff or to the appropriate office contact within CDER/CBER. This should also be the mailing address for the entire submission:

• For a Drug: Food and Drug Administration Center for Drug Evaluation and Research Central Document Room 5901-B Ammendale Rd. Beltsville, Md. 20705-1266
• For a Therapeutic Biological Product: Food and Drug Administration Center for Drug Evaluation and Research Therapeutic Biological Products Document Room 5901-B Ammendale Road Beltsville, MD 20705-1266
• For a Biological Product: U.S. Food and Drug Administration Center for Biologics Evaluation and Research Document Control Center 10903 New Hampshire Avenue Silver Spring, MD 20993-0002

Letter of Support / Authorization

If a sponsor is proposing to evaluate a drug that is the subject of an existing IND, they can request a letter of cross-reference authorization from the sponsor of that existing IND. This permits the sponsor to refer the FDA to the information contained in the referenced IND, and maintain the confidentiality of their proprietary information. The FDA can use the original IND material, along with their own internal reviews of that material to assist in their review process. Additionally, an IND for a drug that has been approved by the FDA for commercial use, may require more information than what is provided in the package insert. Again, the sponsor may request a letter of cross-reference authorization from the commercial sponsor. Commercial sponsors should provide the IND, NDA, or BLA file name, reference number, volume, and page numbers where the FDA can find the information relevant to the referencing IND application. In general, INDs that are withdrawn or inactive cannot be cross-referenced.

Sections of the Initial IND

The initial IND submission to the FDA is broken down into several distinct sections. Each section addresses a topic necessary for FDA review. The links below will provide a detailed description of each section and provide guidance on what information should be included in the IND submission.

The Investigator-Initiated Investigational New Drug (IND) Applications website has all the information to get from start to finish with an application to the FDA.

Introduction

The introduction should briefly describe the research plan submitted in this IND, including a discussion of the disease state to be assessed. The intent of this section is to place the use of the drugs with this indication into perspective for the FDA. This section should include the product’s active ingredients, pharmacological class, structural formula and dosage form, and route of administration. The study objectives and proposed timeline should be stated. Additionally, include the status of the drug in other countries, i.e., if the product has been withdrawn from investigator or marketing for any reason related to safety or effectiveness.

This section will include a brief summary of previous human experience with the drug, with reference to the relevant literature or other INDs, if pertinent. Also, investigational or marketing experience in other countries may be relevant to the safety of the proposed clinical investigation. This topic will be written up in further detail in the “Previous Human Experience” section.

General Investigational Plan

As the studies contained in this IND progress from phase 1 to phases 2 and 3, the contents of this section will change. For the purpose of the initial submission, information that will be relevant for the first year of investigation should be included. Changes to the plan and additional protocols can be included in future annual reports and amendments. This should include:

• The rationale for the drug and/or research study and enough background information on the topic for the FDA to understand the scientific justification for the investigation.
• Identification of the indication to be studied in this investigation, including sub-sets of a more general study population if needed.
• A high-level description of data to be collected and its use in evaluation of the efficacy of the intervention being studied.
• A high-level description of the plan for the first 12 months of clinical investigation. The FDA understands that study plans may change over time.
• The planned number of subjects to be enrolled in the first year of IND activity.
• Any risks of particular severity or seriousness anticipated on the basis of the toxicological data in animals or prior studies in humans with the drug(s) or related drugs. Any study procedures that carry risks of more than minimal severity should be included.

Investigator Brochure

For single site INDs where an NIH Institute or Center (IC) is the Sponsor and an employee of the IC is the investigator, it is generally acceptable to ask for a waiver for the Investigator Brochure, much like a sponsor-investigator study. The following statement may be incorporated into the application:

"As this is a single site study with the investigator initiating the study and being employed by the sponsoring entity, we believe that an investigator’s brochure is not required per 21 CFR 312.55(a)."

If an approved drug is being investigated, then it is appropriate to refer to the labeling and provide a URL link to the most current product label. Links that may be helpful are:

• Drugs@FDA: FDA Approved Drug Products

Letters of Authorization may also be referenced in this section.

If there will be a multi-center (external site) clinical investigation, an Investigator's Brochure should be developed for dissemination to each of the involved study sites and should address the following information:

• A brief description of the active drug substance and the drug product formulation, including the structural formula of the active drug substance, if known.
• A summary of the pharmacological and toxicological effects of the drug in animals and, to the extent known, in humans.
• A summary of the pharmacokinetics and biological distribution of the drug in animals and, if known, in humans.
• A summary of information relating to the safety and effectiveness of the drug in humans obtained from prior clinical studies. (Reprints of published articles describing such studies may be appended to the Brochure if they are anticipated to be useful.)
• A description of possible risks and side effects to be anticipated on the basis of prior experience with the drug under investigation or related drugs, and of precautions or special monitoring to be done as part of the investigational use of the drug.

Proposed Clinical Research

This section should contain the full study protocol document and informed consent document for each planned study.

Informed consent documents should be written in such a way that they can be understood by the general public. Language should be targeted at an elementary grade reading level. It is advisable to keep the document concise for the benefit of the reader. A statement should be included here that informed consent will be obtained by all study participants in accordance with 21 CFR Part 50, Protection of Human Subjects. If the investigation involves an exception from informed consent requirements, this should be stated in this section and the reasoning should be explained.

Chemistry, Manufacturing, and Control Information

If the investigational drug has been marketed, this section may be covered by referring to the product labeling. Refer back to the URL identified in the Investigator's Brochure section, if appropriate. Alternatively, it might be appropriate to refer to a Letter of Authorization if using a drug provided by a commercial company.

Drug Substance

This section should include:

• Description of drug; included should be the physical, chemical, or biological characteristics and evidence supporting structure and identity of the active pharmaceutical ingredient(s)
• Name and address of manufacturer of drug product
• Description of the general method of preparation of the drug substance, including a list of the reagents, solvents, and catalysts used. A detailed flow diagram is suggested as the most effective presentation. More information may be needed to assess the safety of biotechnology-derived drugs or drugs extracted from human or animal or plant sources
• The acceptable limits and analytical methods used to ensure the identity, strength, quality, and purity of the drug substance, with a brief description of the test methods used (i.e., Nuclear Magnetic Resonance, Infrared, UV spectra to prove the identity, and High-Performance Liquid chromatograms to support the purity level and impurities, etc.). Submission of certificates of analysis is also suggested.
• Information to support stability of the drug substance during storage in the intended container closure and during the toxicological and clinical studies

Drug Product

• A list of all components used in the manufacture of the investigational drug product, including both those components intended to appear in the drug product and those which may not appear but which are used in the manufacturing process
• Where possible, the quantitative composition of the investigational drug product, including any reasonable variations that may be expected during the investigational stage
• Brief general description of the manufacturing process (in the form of a flow diagram is suggested) and packaging procedure, as well as other relevant tests, as appropriate for the product. Final specifications for the drug product intended to be used in toxicological and clinical studies should be included. For injectable products, sterility and pyrogenicity tests, endotoxin levels and particulate matter should be included. Submitting a copy of the certificate of analysis of the clinical batch is also suggested. There should be information sufficient to assure the product's stability during the planned clinical studies.
• The acceptable limits and analytical methods used to ensure the identity, strength, quality, and purity of the drug product
• Information to support stability of the drug product during the planned clinical studies

Placebo Product

Include a brief general description of the composition, manufacture, and control of any placebo used in the controlled clinical trial.

Include copies of the label constructed for the study drug and any associated package.

Labels must contain the phrase: "Caution: New Drug - Limited by Federal law to investigational use".

Environmental Assessment

Insert the statement below, unless there is a reason to believe the distribution and use of the drug could have an environmental impact. The FDA may require an environmental analysis to ensure the study agent does not impose an undue environmental hazard. For products already marketed, it may be possible to request and exemption from the requirement to conduct an environmental analysis.

"We request a claim for categorical exclusion for this proposed clinical trial as provided for in 21 CFR Part 312.31(e) in that the drug shipped under this notice is intended to be used in clinical trials in which the amount of waste expected to enter the environment may reasonably be expected to be non-toxic."

Pharmacology and Toxicology Information

As was true for the Chemistry, Manufacturing and Controls section, an authorization letter may be used or a reference to the drug label to satisfy this section. This section is expected to include information about pharmacological and toxicological (laboratory animals or in vitro) studies on the basis that it is reasonably safe to conduct the proposed clinical investigation. The type, duration, and scope of these studies required in the application will depend on the duration and nature of the proposed clinical investigations.

Compliance with Good Laboratory Practice (GLP) is generally expected for pivotal in vitro and in vivo studies submitted in support of an IND application. For each non-clinical laboratory study subject to the GLP regulations, investigators are expected to state in the study report that the study was conducted in compliance with the GLP regulations. If the study was not conducted in compliance with the GLP regulations, there should be a brief statement of the reason for noncompliance.

The IND sponsor should also provide a statement describing where the non-clinical investigations were conducted and the location of all records available for inspection.

Pharmacology and Drug Distribution

This section should include a description of the pharmacologic effects and mechanism of actions of the drug in animals, and information on the absorption, distribution, metabolism, and excretions of the drug.

Note: The regulations do not further describe the presentation of these data, in contrast to the more detailed description of how to submit toxicological data. A summary report, without individual animal records or individual study results, usually suffices. In most circumstances, five pages or less should suffice for this summary. If this information is not known, it should simply be so stated.

Pharmacology Summary and Conclusions

A high-level summary and general conclusions to be drawn from the pharmacology data should be included in this section.

Toxicology: Integrated Summary

This section should include an integrated summary of the toxicological effects of the drug in pre-clinical studies. Expected content elements for describing specific toxicology studies for this section typically include:

• Study title
• Study drug formulation and dosing
• Brief description of the design of the trials
• Systematic presentation of the findings from the animal toxicology and toxicokenetic studies. The format of this part of the summary may be approached from a "systems review" perspective: i.e. CNS, cardiovascular, gastrointestinal, renal, hepatic, genitourinary, hematopoietic and immunologic, and dermal.
• A high-level summary and general conclusions of the preceding toxicology findings.
• Identification and qualifications of the individual(s) who evaluated the animal safety data and concluded that it is reasonably safe to begin the proposed human study. This person(s) should sign the summary attesting that the summary accurately reflects the animal toxicology data from the completed studies.
• A statement of where the animal studies were conducted and where the records of the studies are available for inspection, should an inspection occur.
• According to 21 CFR 312.23(8)(iii) , a statement that the study was conducted in compliance with the good laboratory practices (GLP) in 21 CFR 58 , or, if the study was not conducted in compliance with those regulations, a brief statement of the reason for the noncompliance and the sponsor's view on how such noncompliance might affect the interpretations of the findings.

Toxicology: Full Data Tabulation

The sponsor should submit, for each animal toxicology study that is intended to support the safety of the proposed clinical investigation, a full tabulation of data suitable for detailed review. This should consist of line listings of the individual data points, including laboratory data points, for each animal in these trials along with summary tabulations of these data points. To allow interpretation of the line listings, accompanying the line listings should be either: 1) a brief description (i.e., a technical report or abstract including a methods description section) of the study, or 2) a copy of the study protocol and amendments.

Previous Human Experience

A summary of previous human experience with the drug known to the applicant should be included in this section. If the drug(s) is already marketed in the US, then it may be possible to simply refer to the product labeling. There is no specific format for describing previous human experience with an investigational drug in an IND application. If the drug is a combination of drugs previously investigated or marketed, the information should be provided for each active drug component. However, if any component in such combination is subject to an approved marketing application or is otherwise lawfully marketed in the United States, the sponsor is not required to submit published material concerning that active drug component unless such material relates directly to the proposed investigational use (including publications relevant to component- component interaction). If there is no data on previous human experience for this drug, a statement should be inserted reflecting this under each subheading.

Marketed Experience

This section should provide an overview of the FDA-approved indications for the study drug if it is a commercial product. Reference to the FDA drug labeling for approved indications should be noted here. If the drug was withdrawn from the market for any reason related to safety or effectiveness, identification of the country(ies) where the drug was withdrawn and the reasons for withdrawal should be included.

Prior Clinical Research Experience

If the drug has been the subject of controlled trials, detailed information on trials that are relevant to an assessment of the drug's effectiveness for the proposed investigational use(s) should be provided. Any published material that is relevant to the safety of the proposed investigation or to an assessment of the drug's effectiveness for its proposed investigational use should be provided in full. Published material that is less directly relevant may be supplied by a bibliography.

If there has been no previous human experience, the submission should so state.

Clinical Care Experience

It is not uncommon for marketed drugs to be used in clinical care settings to treat patients for indications that do not have an FDA approval. This is often termed "off-label" use. Any published literature on the safety of the drug in that setting, and if available, published practice guidelines of the use of the drug for standard-of-care and the associated safety information could be referenced here. This is particularly relevant if the patient population treated with this off-label use of the drug is similar to the proposed study population for this IND application.

References used should be listed in this section. Complete reprints of select articles may be provided to aid the FDA reviewers, limited to two to three reprints. FDA does not have access to all journal articles and so including selected reprints can help facilitate the review of an IND application.

Disclosure of Financial Interests

IND sponsors are not required to submit information regarding clinical investigator financial interests or arrangements in IND applications. They are, however, required to collect this information before a clinical investigator participates in a clinical study and clinical investigators are required to disclose financial information to sponsors. The information does not need to be submitted to FDA until a marketing application is submitted containing the results of the covered clinical study.

In the interest of collecting this information at the initial stage of an IND, clinical investigators may also complete a Form FDA 3454 if they have no financial interests or arrangements to disclose, or Form FDA 3455 to disclose the nature of their interests and arrangements.

Additional Information

In certain applications, as described below, information on special topics may be needed. Such information shall be submitted in this section as outlined below.

Otherwise you may simply state 'not applicable'.

Drug Dependence and Abuse Potential

If the drug is a psychotropic substance or otherwise has abuse potential, a section describing relevant clinical studies and experience and studies in test animals should be included.

If this section is relevant to your investigation, please see Guidance for Industry – Assessment of Abuse Potential of Drugs .

Radioactive Drugs

If the drug is a radioactive drug, sufficient data from animal or human studies should be provided, to allow a reasonable calculation of radiation-absorbed dose to the whole body and critical organs upon administration to a human subject. Phase 1 studies of radioactive drugs must include studies which will obtain sufficient data for dosimetry calculations.

If this section is relevant to your investigation, please see Medical Imaging and Drug Development .

Pediatric Studies

If the investigational drug will be studied in pediatric setting, plans for assessing pediatric safety and effectiveness should be provided.

If this section is relevant to your investigation, please see Pediatric Product Development .

Other Information

A brief statement of any other information that would aid evaluation of the proposed clinical investigations with respect to their safety or their design and potential as controlled clinical trials to support marketing of the drug should be included in this section.

End of Life Decisions for Isolated Patients Under New York's Family Health Care Decisions Act

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The most challenging end-of-life cases involve patients who lack capacity and have no surrogate decision-makers. New York's Family Health Care Decisions Act provides alternative criteria for withdrawing or withholding treatment in such cases, including the requirement that the patient "will die imminently, even if the treatment is provided." This article clarifies the interpretation of "imminent" and offers recommendations to improve end-of-life policies, including greater reliance on Ethics Review Committees (ERCs).

INTRODUCTION

Probably the most distressing end-of-life cases involve patients who lack capacity and who are socially isolated – that is, who do not have a health care agent, family member, or friend who knows them, cares about them, and will make decisions for them. [1] Health care professionals caring for these socially isolated patients struggle with exceedingly difficult professional, ethical, and legal issues. [2] Several states have enacted laws with standards and procedures for such decisions. [3] In New York, the Family Health Care Decisions Act (FHCDA) governs end-of-life decisions for most socially isolated patients. [4] This article examines the provisions for socially isolated patients in the FHCDA. While the FHCDA is just one state’s statute, the clinical, ethical, policy, and even interpretive issues addressed here will be instructive to health care professionals and policymakers in other states as well.

Special attention is given to the FHCDA provision that requires, as a basis for withdrawing or withholding treatment from socially isolated patients, a finding that the patient “will die imminently, even if the treatment is provided.” [5] That critical phrase is a source of uncertainty, both with respect to time period that qualifies as “imminently” and to the application of the phrase to DNR orders. [6] A clear, uniform understanding of the “will die imminently clause” will reduce both undertreatment and overtreatment of socially isolated patients at the end of life.

But an additional policy change is needed. This article recommends that, once standards for ethics review committees are strengthened, the FHCDA should be amended to allow the attending physician to decide to withhold or withdraw life-sustaining treatment for a socially isolated patient based on the standards that now apply to surrogate decisions, subject to approval by an ethics review committee. The FHCDA already allows decisions on this basis for socially isolated patients in hospice; [7] the approach should be broadened.

I.     The Family Health Care Decisions Act

The FHCDA governs decisions for patients in hospitals, nursing homes, and hospices who lack capacity and who did not, prior to losing capacity, make the decision personally or appoint a health care agent. [8] The statute governs consent to treatment and decisions to withdraw or withhold life-sustaining treatment. 

In general, the FHCDA provides for the designation of a surrogate decisionmaker from a priority list.  The highest priority category on that list is a court-appointed guardian when there is one.  After that, the list proceeds through levels of close relatives and ends with the category “close friend.” [9]

     a.     A Surrogate Decision to Withdraw or Withhold Life-Sustaining Treatment

Under the FHCDA, a surrogate may decide to withhold or withdraw life-sustaining treatment from the adult patient who lacks decision-making capacity based on the patient’s wishes, if known or ascertainable through reasonable efforts or when the patient’s wishes are unknown and not reasonably ascertainable, on best interests. Whether the patient’s wishes or the best interest standard is applied, certain clinical ethical standards must be met. For example, either:

(i)   treatment would be an extraordinary burden to the patient and the patient has an illness or injury which can be expected to cause death within six months, whether or not treatment is provided; or the patient is permanently unconscious; or

(ii)   the provision of treatment would involve such pain, suffering, or other burden that it would reasonably be deemed inhumane or extraordinarily burdensome under the circumstances, and the patient has an irreversible or incurable condition. [10]    

This standard, referred to in this article as the “surrogate decision-making standard,” does not require a finding that the patient is imminently dying.    

     b.     FHCDA Provisions Regarding Socially Isolated Patients

FHCDA section 2994-g governs decisions for most incapable adult patients without surrogates. Subsections 5 and 5-a establish the three alternative bases for ordering the withdrawal or withholding of life-sustaining treatment for socially isolated adult patients. As explained further below, life-sustaining treatment can be withdrawn or withheld from a socially isolated patient based on:

          (1) judicial approval;

          (2) the “will die imminently” test; or

          (3) decisions regarding hospice care.

     c.     Judicial Approval

First, the FHCDA allows treatment to be withdrawn or withheld from a socially isolated patient if a court finds that the decision meets the surrogate decision-making standard (terminally ill, permanently unconscious, or extraordinary burden). [11] Prior to the FHCDA, a court had no such authority; it could approve the decision only if it found “clear and convincing evidence” of the patient’s “firm and settled commitment” to forgo treatment under the circumstances. [12]    

     d.     The “Will Die Imminently” Test

Second, treatment can be withdrawn or withheld from the socially isolated patient where:

The attending practitioner, with independent concurrence of a second practitioner, determines to a reasonable degree of medical certainty that:

(i) life-sustaining treatment offers the patient no medical benefit because the patient will die imminently, even if the treatment is provided; and

(ii) the provision of life-sustaining treatment would violate accepted medical standards. [13]  

As noted previously, there is uncertainty among clinicians and others regarding the meaning of “will die imminently” [14] — what does it mean and how long a time period is “imminently”?  Or to use a legal lens: how would the phrase “will die imminently” be construed in an administrative or judicial legal proceeding?  

As explained below, the phrase “imminently” clearly includes a period of hours or a few days, probably includes a week and perhaps two weeks, but probably does not include a month or more.

               i.     Administrative And Judicial Definition

There is no NYS Department of Health regulation or guidance that further defines the phrase “will die imminently.” [15] Such state agency regulation or guidance would have been entitled to considerable deference if a court found that the interpretation required specialized knowledge or expertise. [16]  

Moreover, no published judicial opinion interprets the meaning of “will die imminently” in the FHCDA, so there is no binding precedent. 

The words “imminent” and “imminently” appear in several other New York state statutes.  For example, under New York Mental Hygiene Law, confidential mental health information can be disclosed to an endangered individual based on the practitioner’s determination that the patient presents “a serious and imminent danger” to the endangered individual. [17]    The Family Court Act defines “neglected child” to mean a child “in imminent danger of becoming impaired....” [18] Several courts have interpreted those words for the purpose of those other statutes.  In a child neglect case, the NYS Court of Appeals explained that “’ imminent danger’” must be “near or impending, not merely possible.” [19] However, the interpretation of “imminent” for the purpose of statutes other than the FHCDA is not dispositive of its meaning in the FHCDA.

The phrase "imminent death" is also used in Georgia and Vermont laws as a basis for a DNR order. [20]   But the phrase is not defined in those statutes either.

               ii.     Principles Of Statutory Construction

In the absence of administrative guidance or judicial precedent, a court would define “will die imminently” by using familiar principles of statutory construction. [21] Initially it would look to the plain, customary meaning of the words as well as the statutory context.  If the court needed further guidance, it would consider the legislative history and then possibly professional or scholarly interpretations.  A court would be mindful of policy implications, but it could not twist the plain meaning of the words to achieve policy ends.

               iii.     Plain Meaning

Courts typically start with dictionary definitions “as guideposts to determine a word’s ordinary and commonly understood meaning.” [22] Webster’s International Dictionary, Third Edition (1993) defines “imminent” to mean “Ready to take place; near at hand; impending; hanging threateningly over one’s head; menacingly near.” [23] The Oxford English Dictionary defines “imminent” to mean “Of an event (almost always of evil or danger): Impending threateningly, hanging over one's head ready to befall or overtake one close at hand in its incidence coming on shortly.” [24] Merriam-Webster, a commonly used online reference, defines “imminent” as “ready to take place: happening soon.” [25]

Not surprisingly, none of these definitions specify a time period; the term is intentionally imprecise. It is a qualitative, not quantitative, concept.  But it unmistakably means “soon.” 

               iv.     Statutory Context

Courts will also construe a statute as a whole and consider sections together with reference to each other. [26] In this instance, the statutory context is revealing:  one of the other bases in the FHCDA for a surrogate decision to forgo life-sustaining treatment is that “the patient has an illness or injury which can be expected to cause death within six months....” [27] Accordingly, “imminently” must mean something sooner than “within six months.” The Legislature would not have used different phrases for the same time period.  Put differently, if the Legislature meant “within six months,” it knew how to say it.  It used “imminently” to mean something sooner. [28]

               v.     Legislative History

The legislative history of the phrase “will die imminently” is the most revealing guide to its meaning. The FHCDA was based on the 1992 report and recommendations of the New York State Task Force on Life and the Law, When Others Must Choose – Deciding for Patients Who Lack Capacity . [29] The Task Force recommended two bases for a decision to forgo treatment for socially isolated patient: 

          (1)     A decision by the attending physician to withhold or withdraw life-sustaining treatment, based on the standard that would apply to a surrogate, subject to ethics review committee approval; or 

          (2)     “health care without benefit” is defined as follows:

                    a.     An attending physician determines, in accordance with accepted medical standards and to a reasonable degree of medical certainty, that the patient will die within a short time period despite the provision of treatment and that treatment should be withdrawn or withheld; and

                    b.     one other physician selected by the hospital concurs in this determination. [30]

The Task Force’s proposed clause in paragraph (2), “will die within a short time period,” is the direct forerunner to PHL 2994-g’s “will die imminently” clause. Moreover, as discussed below, the Task Force regarded “a short time period” and “imminently” as having the same meaning.

The Task Force report devotes a full chapter to “Deciding for Adults Without Surrogates,” with a section on “Treatment Without Medical Benefit.” Its discussion in that chapter in support of the “will die within a short period” standard uses all of these phrases for the same concept:

(i) “during the final days and hours of the dying process”

(ii) “the final days of their dying process”

(iii) “at the end stage of their dying process”

(iv) “will die within a short period even if treatment is provided”

(v) “patients who are imminently dying”

Ultimately, the NYS Legislature deleted the first option of allowing a decision for a socially isolated patient based on the surrogate decision-making standard subject to ethics review committee review proposed by the Task Force.  Further below, this article recommends revisiting that option.

More to the point for present purposes, the Legislature modified the Task Force proposed phrase “will die within a short time period” to “will die imminently.”  But neither phrase is quantifiable and, as noted above, the Task Force used them interchangeably.

This article cannot provide an authoritative definition of the precise time period conveyed by the phrase “will die imminently.”  That would need to come from a court, the legislature or a state agency.  But in the absence of such definition, principles of statutory construction indicate that “imminently” clearly includes a time period of hours or a few days, probably includes a week and perhaps two weeks, but probably does not include a month or more.

This conclusion may seem unremarkable.   But it may help counter interpretations at opposite ends of the spectrum.  If “imminently” is read to mean that the patient must be expected to die within minutes or hours for treatment to be withheld or withdrawn, clinicians may feel compelled to provide highly aggressive treatment to the dying socially isolated patient that most would regard as extraordinarily burdensome in light of minimal benefit.  On the other hand, if “imminently” is read to mean that the patient will probably die sometime in the next few months but not the next few weeks, a decision to withhold or withdraw treatment from the socially isolated seems to involve more of a value judgment than a medical judgment.

     d.     DNR Orders

Applying the term “will die imminently” to DNR orders raises special issues. As explained below, the phrase, as applied to a DNR order means that a DNR order can be written based on a finding that in the event of cardiac arrest, the patient will die imminently even if the treatment is provided.   The phrase does not require a finding that the patient is imminently dying at the time the DNR order is written.   

A do-not-resuscitate (DNR) order directs the medical staff not to attempt cardiopulmonary resuscitation if and when, at some point in the future, the patient goes into cardiac arrest. New York’s former DNR law, in effect from 1988 to 2010, created a process and standards for securing surrogate consent to a DNR order. [31] For socially isolated patients, it provided that a DNR order could be entered based on an attending physician and concurring physician determination that resuscitation would be “medically futile.” Per the former statute, “medically futile” means that “cardiopulmonary resuscitation will be unsuccessful in restoring cardiac and respiratory function or that the patient will experience repeated arrest in a short time period before death occurs.” [32]

Significantly, the standard to enter a DNR order for socially isolated patient did not require a finding about the patient’s condition or life-expectancy at the time of writing the order; it just required a finding about whether, in the event of a future cardiac arrest, resuscitation would work.  

The FHCDA was developed to extend the DNR Law to a broader range of life-sustaining treatments. [33] The Task Force and legislature, in proposing the FHCDA, adopted or adapted DNR Law provisions on, among other topics, determining incapacity, a surrogate priority list, clinical predicates to support a surrogate decision to forgo life-sustaining treatment, the patient‘s wishes or best interest standard, and the use of an ethics committee.

With respect to socially isolated patients, the FHCDA could not simply reproduce the DNR Law’s provision on medical futility because the DNR Law provision was treatment-specific: it referred only to the effectiveness of cardiopulmonary resuscitation.  The FHCDA needed to extend the DNR concept of medical futility to encompass decisions about ventilators, feeding tubes, dialysis, antibiotics, and more.  Accordingly, the DNR provision on the futility of resuscitation, extended to other treatments, became in the Task Force’s proposal a finding “that the patient will die within a short time period despite the provision of treatment.” In the final FHCDA, that phrase was changed to a finding that “the patient will die imminently, even if the treatment is provided.”

That background illuminates the meaning of the FHCDA term “will die imminently” as applied to a DNR order:  It means that a DNR order can be written for a socially isolated patient based on a finding that in the event of cardiac arrest, the patient will die imminently, even if the treatment is provided.

The language of the provision supports the above conclusion. “Will die imminently even if the treatment is provided” ties the phrase “will die imminently” to the time the treatment, resuscitation (when the patient has a cardiac arrest), is provided. 

Consider a socially isolated patient dying from cancer that has metastasized. The attending practitioner considering a DNR order may not be able to state with certainty that the patient “will die imminently.”  But the physician may well be able to say with certainty that when the disease finally causes the patient’s heart to stop, the patient “will die imminently, even if the treatment is provided.” 

This is the standard that was in effect under the DNR Law from 1988 to 2010.  Neither the Task Force nor the NYS Legislature intended to disturb that standard in proposing and enacting the FHCDA. As others have noted, “Although the law now uses different words, there are few, if any, cases in this ... category where a DNR order legally could have been issued before FHCDA but could not be issued under FHCDA.” [34]

A NYS Bar Association website, “The Family Health Care Decisions Act Resource Center,” endorses this view. [35]   It includes an FAQ that states as follows:

Health Care Decisions for Adult Patients Without Surrogates. N.Y. PHL § 2994-g) Q – Under the former DNR law, a DNR order could be entered for an incapable patient who did not have a surrogate if the physician and a concurring physician determined that resuscitation would be “medically futile” (if CPR would “be unsuccessful in restoring cardiac and respiratory function or that the patient will experience repeated arrest in a short time period before death occurs”). Can a practitioner still do that? A – The language of the standard has changed, but it still ordinarily supports the entry of a DNR order if resuscitation would be “medically futile” as defined above. Under the FHCDA, the practitioner and a concurring practitioner would need to determine that (i) attempted resuscitation (in the event of arrest) would offer the patient no medical benefit because the patient will die imminently, even if the treatment is provided; and (ii) the attempt would violate accepted medical standards. (Emphasis added).

This NYS Bar Association FAQ, while not an authoritative source of law, was written, reviewed and approved by a broad range of experienced health lawyers and provides strong support for a facility or practitioner that follows this approach.

Moreover, an article by clinicians and bioethicists at the New York City Health + Hospitals, including bioethicist Nancy Dubler, adopted this position as well:

Life-sustaining treatment decisions should be seen as situation-specific, as they depend on the treatment in question and on the medical condition and prognosis of the individual at the time the adverse event occurs, such as cardiopulmonary arrest. Based upon the dismal CPR survival data for nursing home residents with dementia, in the event of cardiac arrest, CPR likely will result in imminent death. [36]

The DNR laws in other states specify this temporal concept.  For instance, a provision in Vermont’s DNR law allows a physician to write a DNR order for any patient (not just isolated patients) upon a certification “that resuscitation would not prevent the imminent death of the patient, should the patient experience cardiopulmonary arrest. . . .” [37]

It would seem that the same conclusion can be reached for a do-not-intubate (DNI) order, a nursing home do-not-hospitalize order, or any other order that directs the withholding or withdrawal or life-sustaining treatment in the event of a future clinical contingency.  Such orders are distinguishable from noncontingent orders meant to be carried out immediately, such as discontinuing a ventilator or feeding tube.  But these treatments may raise different clinical and ethical issues.  In any case, the clearest case, based on words and history, relates to DNR orders.

To be sure, it would have been preferable if the drafters of the FHCDA specified, as Vermont did, that for the purpose of a DNR order, the test is whether, in the event of cardiac arrest, the patient will die imminently, even if the treatment is provided.  And it would be helpful if policymakers clarified this point now. [38] Legislative bills to accomplish this have been introduced repeatedly. [39]   The state Department of Health could also accomplish such clarification by a “Dear CEO/Administrator Letter,” [40] or by revising the MOLST checklist for adults without surrogates. [41] Such clarification would help decrease uncertainty and misunderstanding among health care professionals and their advisers and allow DNR decisions for socially isolated patients based on longstanding, ethically sound principles.

But even without an official pronouncement, the words and history of the “will die imminently” provision make clear what was meant.

As an aside, advances in resuscitative techniques, such as the increased deployment of Extracorporeal Membrane Oxygenation (ECMO), are increasing the duration of patient survival after resuscitation. [42]   ECMO raises complex medical and ethical issues regarding, among other matters, whether a patient is a candidate for the procedure, [43] when to discontinue ECMO after it has commenced, and what a DNR order means as applied to a patient on ECMO. [44] These fraught issues are beyond the scope of this article.  In any case, if and when ECMO becomes a standard of care response to an inpatient cardiac arrest, the FHCDA test for a “do not ECMO order” for a socially isolated patient would seem to be whether, in the event of cardiac arrest, the patient will die imminently even if ECMO is provided. This could lead to a different result than applying the standard to a non-ECMO resuscitation. But this rote application of the FHCDA test would not take into account the exceptionally scarce availability of ECMO equipment and staff, which compels distributive justice considerations, specifically resource allocation, well beyond those raised by CPR. It makes the treatment akin in many ways to decisions about scarce transplantable solid organs, or ventilators in a pandemic. So, there is an ethical argument for devoting ECMO to patients who have a prospect of post-ECMO life.  Again, these are issues beyond the scope of this article.   

     f.    Decisions Regarding Hospice Care

A 2015 amendment to the FHCDA added a third FHCDA basis for withdrawing or withholding treatment from a socially isolated patient. [45] It authorizes the attending practitioner to make “decisions regarding hospice care” for the patient, subject to several oversight requirements. [46] The decision must be made in consultation with staff directly responsible for the patient’s care, with the concurrence of another practitioner, and – significantly — with the review and approval of an ethics review committee. [47]

The FHCDA defines “decisions regarding hospice care” to mean “the decision to enroll or disenroll in hospice, and consent to the hospice plan of care and modifications to that plan.” [48] The reference to “plan of care” signifies that the attending is not simply making the hospice enrollment decision, but the treatment plan as well. The provision requires the practitioner to base his or her decisions regarding hospice care for the socially isolated patient on the principles that would apply to surrogate decisions, including the surrogate decision-making standard for end-of-life decisions. [49] That standard does not require a finding that the patient “will die imminently.”

Data is not available to the extent to which New York hospitals, nursing homes, and practitioners are invoking or even aware of this hospice-related provision as a basis for decisions for socially isolated patients.  But by referring to the surrogate decision-making standard, as opposed to the “will die imminently” standard, the provision gives the practitioner and ethics committee a role akin to that of a joint surrogate for the hospice-eligible socially isolated patient. In fact, it approximates the Task Force’s original proposal, which would have allowed the withdrawal or withholding of life-sustaining treatment from an isolated patient based: a decision by the attending physician applying the standard that would apply to a surrogate, subject to ethics review committee approval. [50]         

II.     Policy Recommendation

This paper proposes to strengthen ethics review committee standards, then allow the attending practitioner to make end-of-life decisions for a socially isolated patient based on the surrogate decision-making standard, subject to ethics review committee approval.    

Clarifying the “will die imminently standard” will improve the quality of care for dying socially isolated patients.  But will not remedy another gap – the need to allow carefully considered end-of-life decisions for socially isolated patients who are not expected to die imminently, but who meet the criteria described in the surrogate decision-making standard (a decision based on the patient’s wishes or, if those are not reasonably known, the patient’s best interests and, summarized, a finding that the patient is terminally ill or permanently unconscious, or the proposed treatment would impose an extraordinary burden on the patient). [51]  

The Task Force’s original 1992 proposal would have addressed this gap by allowing a decision by the attending physician to withhold or withdraw life-sustaining treatment for an isolated patient based on the surrogate decision-making standard, subject to ethics review committee approval. [52] This option would allow for humane, patient-centered, comfort care-oriented end-of-life decisions for socially isolated patients in cases that are not in the “will die imminently” category.  

Moreover, this option dovetails well with the “will die imminently” option: The physician or ERC option addresses cases that include prominent ethical or nonmedical questions. For example, what are this socially isolated patient’s wishes or best interests?  What are the benefits and burdens of the treatment? These questions make it necessary and appropriate to convene an ERC to review and possibly approve a decision.  In contrast, the “will die imminently” basis is primarily a medical question (will the treatment work?). An ERC has no apparent role in that determination unless there is a dispute. [53]

Indeed, allowing the physician or ERC option may reduce concerns about the meaning of “will die imminently” and the reliability of a prognosis that the patient will die imminently. If the attending practitioner is uncertain about whether the patient “will die imminently” but believes comfort care is appropriate for the patient, she or he would be able to refer the recommended course of treatment to the ERC.

Reliance on institutional ethics committee approval for end-of-life decisions for isolated patients is a hardly novel idea. [54] The FHCDA itself already relies upon an ERC to approve the practitioner’s decision about hospice, including a hospice plan of care. [55]  It also makes three other types of end-of-life decisions that are subject to ERC approval. [56] Moreover, some New York hospitals or nursing homes require ERC approval for end-of-life decisions even when applying the “will die imminently” standard. [57]

Elsewhere, some state’s laws recognize a role for ethics committees in decisions for socially isolated patients (Alabama, Arkansas, Georgia, and Tennessee place ethics committees into the priority list of default surrogates) and in other states, hospitals rely upon ethics committees for such decisions without statutory authority. [58]  

There is a strong case in New York for allowing end-of-life decisions for socially isolated patients who do not meet the “imminently dying” criteria based on a practitioner applying the FHCDA’s surrogate decision-making standard, subject to ERC approval.   

III.     Criticism of Reliance on Ethics Review Committees

This proposal will encounter serious substantive criticisms, particularly regarding the role of the ERC. [59]  

The foremost criticism is a concern that, in some cases, the attending physician and ERC may make decisions that undervalue the life of the socially isolated patient who is severely and irreversibly ill but not imminently dying. That risk is even greater for socially isolated patients who face health system discrimination for other reasons: people with physical, mental, or developmental disabilities, poor patients, minority patients, patients with substance abuse-related conditions, prisoners, and very elderly patients.

That concern is very real. But the remedy should not be to compel aggressive treatment in all such cases; that approach fails to consider the particulars of each case and can also cause terrible harm to socially isolated patients. The option of involving a court—apart from the delay and expense—does not really address the concern: it transfers decision-making to a judge who is apt to be inexperienced in these matters and may exhibit the same bias.  

One argument for referring such cases to courts is that courts, unlike ERCs, will apply procedural due process in reaching a decision. [60] Typical due process elements are written notice, hearing, legal representation, right to present evidence, rules about the admissibility of evidence, an impartial decisionmaker, written decision, or appeal rights. But these principles are designed to ensure fairness in adversarial procedures. There is a strong case to apply them when the ERC hears and is empowered to resolve a dispute.  However, the ERC role envisioned here does not involve dispute resolution. It involves reviewing a decision made on behalf of a socially isolated, incapable, non-objecting patient, based on the patient’s wishes, if known, or else the patient’s best interests. This is a part-medical and part-ethical inquiry.  It is emphatically not an adversarial procedure seeking to deprive the patient of rights. 

To be sure, procedural due process is intended to achieve fairness and thoroughness, and some elements of due process would enhance any formal review, including an ERC review. Moreover, if any person connected with the case brings an action to challenge or block an ERC decision, far more processes will be due. The full panoply of judicial-type due process elements should not be grafted onto a physician and ERC’s non-adversarial review of a decision on behalf of the socially isolated patient.   

There is another persuasive argument for caution:  FHCDA ethics review committees have existed in New York since 2010, yet there is little to no information on how well they work in their statutory role. Who is on them?  Do they have significant conflicts of interest?  What are their credentials? Do they have training in the legal and ethical principles they should follow?  How do they collect information about patient wishes and values? Particularly little is known about their current role in approving end-of-life decisions for socially isolated patients in hospice. 

Researchers at Massachusetts General Hospital conducted a retrospective cohort study of ethics committee consultations involving decision-making about life-sustaining treatment for socially isolated patients from 2007 to 2013. [61] They recommended caution before endorsing ethics committees as final decision maker for socially isolated patients. 

Another prominent study surveyed hospitals regarding ethics consultants and ethics consulting. [62] It does not address the role of the ethics committee in making decisions for socially isolated patients. However, some of its inquiries would also be relevant to ethics committees with decision-making authority, including:  Is their financial support adequate? How do they gather information? What records do they keep? How are they evaluated? 

Before expanding the role of ERCs to include end-of-life decisions for socially isolated patients, there is a need for further study. (As of this writing, the Empire State Bioethics Consortium [63] is undertaking just such study.) Depending in part on the findings of a study, consideration must also be given to improving the ERC structure and practices.   For instance, hospitals and ERCs could be encouraged, or even required, to follow model policies regarding: 

(i) Addressing conflicts of interest;

(ii) Addressing bias against patient subpopulations;

(iii) Training in relevant principles of medical ethics and law;

(iv) Procedural steps to follow in end-of-life decision cases, including steps to ascertain patient wishes; Institutional retrospective review of ERC decisions in end-of-life cases (e.g., by the hospital quality assurance committee or other body);

(v) Data collection, subject to QA confidentiality and privilege protections.  

In short, ERCs need to adopt some of the formalities that apply to institutional review boards. [64]   

With additional rules and safeguards, and with increased professionalism of ERCS, end-of-life decisions for socially isolated patients could be based on a physician applying the surrogate decision-making standard, subject to ERC approval.

Additional rules and safeguards, informed by data from studies, will enhance the professionalism of ERCs and the quality of their decision-making. After that step, the FHCDA should be amended to add a fourth basis for an end-of-life socially isolated patient:  a decision by the attending physician based on the surrogate decision-making standard, subject to ERC approval. This would allow for patient-centered end-of-life care for the socially isolated patient. 

New York’s Family Health Care Decisions Act authorizes the withdrawal or withholding of life-sustaining treatment from an incapable, socially isolated patient, among other instances, if the attending practitioner finds that the patient "will die imminently, even if treatment is provided.” That phrase is a source of uncertainty, both with respect to time period that qualifies as “imminent” and to the application of the phrase to DNR orders. This study of the phrase, particularly the legislative history of the phrase, indicates that the term “imminently” clearly includes a time period of hours or a few days, probably includes a week and perhaps two weeks, but probably does not include a month or more.  

Moreover, with respect to DNR orders, a study of the phrase and its legislative history indicates that a DNR order can be written for a socially isolated patient based on a finding that in the event of cardiac arrest, the patient will die imminently even if the treatment is provided. The clause does not require a finding that the patient is imminently dying at the time the DNR order is written. 

Clarifying the “will die imminently standard” will improve the quality of care for dying socially isolated patients, but it will not allow carefully considered end-of-life decisions for socially isolated patients who are not imminently dying, but who meet the criteria described in the surrogate decision-making standard. Policymakers should consider strengthening the standards for ethics review committees to make them more professional. With such changes, the FHCDA should be amended to authorize the attending physician to make an end-of-life decision for an incapable isolated patient based on the same standards that would apply to a surrogate (not the “imminently dying” standard), subject to ERC review and approval. This change will result in more humane, patient-centered end-of-life decisions for socially isolated patients in New York.

[1] N. Karp and E. Wood, Incapacitated and Alone: Health Care Decision-making for Unbefriended Older People. (American Bar Association, Commission on Law and Aging. 2003 Washington, D.C.).

[2] See e.g., H. Kaplan, “Representing Unrepresented Patients,” (Letter from the Editor) AMA Journal of Ethics 21:7:549 (2019) https://journalofethics.ama-assn.org/article/representing-unrepresented-patients/2019-07; T. Dempsey and E.S. DeMartino, “How Should Clinicians Navigate Decision Making for Unrepresented Patients?” AMA Journal of Ethics, Case and Commentary.  21:7:559 (2019); N. Sharadin, “Should Aggregate Patient Preference Data Be Used to Make Decisions on Behalf of Unrepresented Patients?”, AMA Journal of Ethics, Case and Commentary.21:7:566 (2019) https://journalofethics.ama-assn.org/article/should-aggregate-patient-preference-data-be-used-make-decisions-behalf-unrepresented-patients/2019-07; D. Ozar, “Who Are “Unrepresented Patients” And What Counts As “Important” Medical Decisions for Them?” AMA Journal of Ethics, Medicine and Society, 21:7:611 (2019) https://journalofethics.ama-assn.org/article/who-are-unrepresented-patients-and-what-count-important-medical-decisions-them/2019-07; T. Pope, “Five Things Clinicians Should Know When Caring for Unrepresented Patients.” AMA Journal of Ethics 21:7:582 (2019) https://journalofethics.ama-assn.org/article/five-things-clinicians-should-know-when-caring-unrepresented-patients/2019-07.

[3] Meisel, A., K.L. Cerminara and T.M. Pope, Right to Die: The Law of End-of-Life Decision-making (Third Edition 2004.) §8.05; T. Pope, 2017.

[4] N.Y. Public Health Law Art. 29-CC. https://www.nysenate.gov/legislation/laws/PBH/A29-CC The FHCDA does not govern (i) end-of-life decisions for people with developmental disabilities; those are governed by NY Surrogate’s Court Procedure Act §1750-b; or (ii) certain health care decisions for people in mental health hospitals or units, which are governed by Office of Mental Health regulations.  Decisions for isolated patients who have a developmental disability or mental illness can be made by a Surrogate Decision Making Committee (SDMC) established by N.Y. Mental Hygiene Law Article 80.

[5] N.Y. Public Health Law § 2994-g.5(b). https://www.nysenate.gov/legislation/laws/PBH/2994-G

[6] This statement is largely based on my experience as counsel to a health care system, my participation in professional conferences on this issue, and my discussions with clinicians, bioethics professionals, and health care attorneys. But also, compare e.g., Howard J. Finger, James Zisfein, Khoi Luong, Cheryl A. Dury, Ravindra Amin, Steven Hahn, Albina Shkolnik, and Nancy Neveloff Dubler, “Life-Sustaining Treatment Decisions for Unbefriended Nursing Home Resident: Application of a Clinical Ethics Algorithm,” NYSBA Health Law J , Fall 2018 at p.81 https://nysba.org/NYSBA/Publications/Section%20Publications/Health/PastIssues1996present/2018/HealthLawJournal-Fall2018.pdf#page=82 (“imminently” is longer than “immediately” but should be no longer than a few weeks or months”) with Robert S. Olick, K. Faber-Langendoen, “Caring for Patients without Surrogates Under the Family Health Care Decisions Act,” https://www.upstate.edu/bioinbrief/articles/2011/2011-03-case-study-patients-without.php (“likely to die within a matter of days to weeks (not weeks to months)”). With respect to confusion about the application of the FHCDA standard to DNR orders, see Elizabeth Dzeng, Thomas Bein, and J Randall Curtis, “The Role of Policy and Law in Shaping the Ethics and Quality of End-of-life Care in Intensive Care,” Intensive Care Med. 2022 Mar; 48(3): 352-354 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8883558/

[7] N.Y. Public Health Law § 2994-g.5-a. https://www.nysenate.gov/legislation/laws/PBH/2994-G

[8] R. Swidler, “New York’s Family Health Care Decisions Act: The Legal and Political Background, Key Provisions and Emerging Issues,” New York State Bar Journal, June 2010.   https://nysba.org/NYSBA/Public%20Resources/Family%20Healthcare%20Decisions%20Act%20Resource%20Center/FHDAC%20Files/SwidlerHealthJournSpr10.pdf Life-sustaining treatment decisions for patients with intellectual or developmental disabilities are governed by separate laws:  the “Health Care Decisions Act for People with Intellectual or Developmental Disabilities” N.Y. Surrogate’s Court Procedure Act § 1750-b and, for isolated patients with mental disabilities, N.Y. Mental Hygiene Law Article 80 Surrogate Decision-making Committees.   

[9] N.Y. Public Health Law §2994-d.1. https://www.nysenate.gov/legislation/laws/PBH/2994-D

[10] N.Y. Public Health Law §2994-d.5. https://www.nysenate.gov/legislation/laws/PBH/2994-D

[11] N.Y. Public Health Law §2994-g.5(a). https://www.nysenate.gov/legislation/laws/PBH/2994-D

[12] Matter of O’Connor (Westchester County Med. Ctr. ), 72 N.Y.2d 517 (1988) https://casetext.com/case/matter-of-oconnor-40; Matter of Storar and Matter of Eichner v Dillon ,  52 N.Y.2d 363 (1981) https://casetext.com/case/matter-of-eichner-fox , https://casetext.com/case/matter-of-storar-2

[13] N.Y. Public Health Law § 2994-g.5(b).  https://www.nysenate.gov/legislation/laws/PBH/2994-G

[14] See note 7 supra. Most of the language in the provision is not problematic. The meaning of “no medical benefit” is clear because the clause itself supplies the definition: it means that “the patient will die imminently, even if the treatment is provided.”  With respect to the requirement that “the provision of life-sustaining treatment would violate accepted medical standards,” if the patient will die imminently, even if the treatment is provided, the treatment has no medical benefit.  Providing a treatment that has no medical benefit is not consistent with accepted medical standards.  American Medical Association Code of Ethics 2024, § 5.5.  https://code-medical-ethics.ama-assn.org/ethics-opinions/medically-ineffective-interventions (Although, despite medical standards, treatment is sometimes provided toward the end-of-life for non-medical reasons, such as acceding to patient or family requests, or to avoid real or perceived legal risk.  See New York State Task Force on Life and the Law 1992, supra note 7, p.169.)

Finally, the requirement that the determination must be made with “a reasonable degree of medical certainty,” employs a phrase that is commonly used in the FHCDA and other New York health laws. E.g., N.Y. PHL § 2994-c (determination of incapacity); N.Y. PHL §2994-d.5 (surrogate decision-making standard).

As an aside, a recent study provides reassurance that clinicians are generally accurate at identifying patients who are expected to die within 60 days and particularly good at identifying patients who are likely to die within 14 days. M. Orlovic, et al., “Accuracy of Clinical Predictions of Prognosis at The End-Of-Life: Evidence from Routinely Collected Data in Urgent Care Records,” 2023, BMC Palliative Care 22:51 (2023) https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-023-01155-y.

[15] The NYS Department of Health approved a Medical Orders for Life-Sustaining Treatment (MOLST) form and posted it on its website.   https://www.health.ny.gov/professionals/patients/patient_rights/molst/ .  That site includes Checklist 4 for “Adult without FHCDA Surrogate.”  But the checklist simply recites the “imminently dying” test without further guidance.

[16] Wang v. James , 40 N.Y.2d 497 (2023). https://law.justia.com/cases/new-york/court-of-appeals/1976/40-n-y-2d-814-0.html A recent decision of the United States Supreme Court struck down the “Chevron Doctrine” whereby courts had been directed to defer to an agency’s interpretation of statutes the agency administers.  Loper Bright Enterprises v. Raimondo, U.S. S.Ct. Slip Op. 22-451 (June 28, 2024.) But that decision does not affect the deference state courts accord to state agency interpretations of state statutes.

[17] N.Y. Mental Hygiene Law §33.13(c)(6) https://www.nysenate.gov/legislation/laws/MHY/33.13

[18] N.Y. Family Court Act § 1012(f)(i). https://www.nysenate.gov/legislation/laws/FCT/A10P1

[19] Nicholson v. Scoppetta , 3 N.Y. 3d 357, 368, (2004). https://www.nycourts.gov/LegacyPDFS/IP/cwcip/Training_Materials/FP_Training/Nicholson_V_Scoppetta-3N.Y.3D357.pdf

[20] O.C.G.A. §31-39-1.1 (Georgia) https://law.justia.com/codes/georgia/title-31/chapter-39/; 18 V.S.A. §9708(d)(3)(B) (Vermont) https://legislature.vermont.gov/statutes/section/18/231/09708.

[21] People v. Williams , 37 N.Y.2d 314 (2021). https://case-law.vlex.com/vid/broughton-v-state-no-887340191

[22] People v. Williams , 2021.

[23] Webster's Third New International Dictionary of The English Language, Unabridged (1993).

[24] Oxford English Dictionary, Second Edition (1989) Oxford, U.K.

[25] Merriam-Webster online .  https://www.merriam-webster.com/dictionary/imminent.

[26] Peyton v. NYC Board of Standards and Appeals , 36 N.Y.3d 271 (2020). https://casetext.com/case/hoffman-v-nyc-bd-of-standards-appeals-in-re-peyton-ex-rel-peyton

[27] N.Y. Public Health Law §2994-d.5(a)(i). https://www.nysenate.gov/legislation/laws/PBH/2994-D

[28] H.G. Finger, C.A. Dury, G.R. Sansone, R.N. Rao, N.N. Dubler.  “An Interdisciplinary Ethics Panel Approach to End-of-Life Decision Making.” Journal of Clinical Ethics . 33:2 (2022).

[29] New York State Task Force on Life and the Law, When Others Must Choose: Deciding for Patients Without Capacity. 1992. Albany, NY.  ISBN: 1881268004. https://purl.nysed.gov/nysl/27683657 .   For a description of the Task Force, its background and reports, see https://en.wikipedia.org/wiki/New_York_State_Task_Force_on_Life_and_the_Law .  I was Staff Counsel to the Task Force from 1985 – 90, and a member of the Task Force from 2011 to the present but was not affiliated with the Task Force at the time it issued this report. I also authored the Wikipedia article cited in this note.

[30] New York State Task Force on Life and the Law, pp. 259-60 (Emphasis added). https://purl.nysed.gov/nysl/27683657

[31] N.Y. Public Health Law Article 29-B, repealed by NY Laws of 2023, Chapter 23. https://www.nysenate.gov/legislation/bills/2023/S8059

[32] Former New York Public Health Law § 2962.12. https://www.nysenate.gov/legislation/laws/PBH/12

[33] New York State Task Force on Life and the Law 1992, Preface and Chapter 12. https://purl.nysed.gov/nysl/27683657

[34] K. Lipson and J. Karmel, “Honoring Patient Preference at The End of Life: The MOLST Process and the Family Health Care Decisions Act,” NYSBA Health Law Journal 16:1 (2011). https://molst.org/wp-content/uploads/2018/11/Lipson.Karmel.HealthLawJournal.MOLST_.2011.pdf .    But see Dzeng, 2022 (the FHCDA standard for DNR futility is being interpreted as narrower than the former DNR Law standard for futility).

[35] New York State Bar Association (2020) Family Health Care Decisions Act Resource Center .  https://nysba.org/fhcda-resource-center.   I was the principal author of the FAQ cited above, but all the FAQs were reviewed and approved by seven other editorial board members.   

[36] Finger, 2022.

[37] 18 V.S.A. § 9708(c)(3)(B) https://legislature.vermont.gov/statutes/section/18/231/09708; O.C.G.A. §31-39-1 et. seq. https://law.justia.com/codes/georgia/title-31/chapter-39/

[38] J.J. Fins, and R.N. Swidler, “A Proposal to Restore Medical Futility as A Clinical Basis for A DNR Order Under New York Law,” NYSBA Health Law Journal 22:1 (2017).

[39] The most recent versions are (NY Senate Bill 2894 (Rivera) (2023) and NY Assembly Bill 7178 (Dinowitz) (2023).

[40] NYS Department of Health – Dear Chief Executive Letters https://www.health.ny.gov/professionals/hospital_administrator/letters/.

[41] https://www.health.ny.gov/professionals/patients/patient_rights/molst/docs/checklist_4.pdf.

[42] H. Ouyang, “The Race to Reinvent CPR,” NY Times , March 27, 2024, NY Times online https://www.nytimes.com/2024/03/27/magazine/ecpr-cardiac-arrest-cpr.html.

[43] I. Wolfe, “On Not Recommending ECMO, Hastings Center Report ,” September-October 2020 https://onlinelibrary.wiley.com/doi/full/10.1002/hast.1177.

[44] E.C. Metzer, N.S. Ivascu and J.J. Fins, “DNR and ECMO: A Paradox Worth Exploring,” Journal of Clinical Ethics 25, note 1 (Spring 2014):13-9 https://pubmed.ncbi.nlm.nih.gov/24779313/.

[45] Chapter 107, New York Laws of 2015, enacting Public Health Law § 2994-g.5-a. https://www.nysenate.gov/legislation/laws/PBH/2994-G

[46] T. Kirk and R. Seigel, “Decisions Regarding Hospice Care for Isolated Patients: A Guide to the 2015 Amendment of The Family Health Care Decisions Act”, NYS Bar Association Health Law Journal 21:3 (2016) https://philpapers.org/rec/KIRDRH; A. Hulkower, G. Garijo-Garde and L. Flicker, “Should Dialysis Be Stopped for An Unrepresented Patient with Metastatic Cancer? American Medical Association Journal of Ethics 21:7, 575 (2019) at 588 https://journalofethics.ama-assn.org/article/should-dialysis-be-stopped-unrepresented-patient-metastatic-cancer/2019-07.

[47] N.Y. Public Health Law § 2994-g.5-a. https://www.nysenate.gov/legislation/laws/PBH/2994-G

[48] N.Y. Public Health Law §2994-a.5-a. https://www.nysenate.gov/legislation/laws/PBH/2994-A

[49] N.Y. Public Health Law §2994-g.5-a. https://www.nysenate.gov/legislation/laws/PBH/2994-G 

[50] New York State Task Force on Life and the Law, https://purl.nysed.gov/nysl/27683657

[51] Under the surrogate decision-making standard, life-sustaining treatment can be withdrawn or withheld when:  (i)  treatment would be an extraordinary burden to the patient and the patient has an illness or injury which can be expected to cause death within six months, whether or not treatment is provided; or the patient is permanently unconscious; or (ii)  the provision of treatment would involve such pain, suffering or other burden that it would reasonably be deemed inhumane or extraordinarily burdensome under the circumstances; and the patient has an irreversible or incurable condition. N.Y. Public Health Law §2994-d.5. https://www.nysenate.gov/legislation/laws/PBH/2994-D

[52] New York State Task Force on Life and the Law, pp 259-60. https://purl.nysed.gov/nysl/27683657

[53]  New York State Task Force on Life and the Law, pp 259-60. https://purl.nysed.gov/nysl/27683657

[54] F. Rosner, “Hospital Medical Ethics Committees: A Review of Their Development,” Journal of the American Medical Association 253(18); (1985) 2693-97.

[55] N.Y. Public Health Law § 2994-g.5-a. https://www.nysenate.gov/legislation/laws/PBH/2994-G

[56] Specifically: in a nursing home, ERC approval is required for a surrogate decision to withdraw or withhold life-sustaining treatment from a patient who is not terminally ill or permanently unconscious (based on extraordinary burden. PHL §2994-d.8(b); In a general hospital, ERC approval is required for the withdrawal or withholding of artificial nutrition and hydration if the attending practitioner objects to such decision by a surrogate. PHL §2994-d.8(c); ERC approval is required for a decision to withdraw or withhold life sustaining treatment from an emancipated minor Public Health Law §2994-3.(3)(a). https://www.nysenate.gov/legislation/laws/PBH/2994-D 

[57] Finger,2022.

[58] Pope, 2019.

[59]     ERCs will also be denounced by some as “death panels.” This article focuses on substantive ethical and policy criticisms but recognizes that there is a volatile political dimension to this as well.      

[60] T. Pope, “The Growing Power and Healthcare Ethics Committees Heightens Due Process Concerns,” Cardozo Journal of Conflict Resolution 15:425 (2014) https://open.mitchellhamline.edu/cgi/viewcontent.cgi?article=1278&context=facsch.

[61] A.M. Courtwright, J. Abrams and E. Robinson. “The Role of a Hospital Ethics Consultation Service in Decision Making for Unrepresented Patients.”  Journal of Bioethics Inquiry 14(2): 241-250 (2017).

[62] Ellen Fox, Marion Danis, Anita J. Tarzian & Christopher C. Duke, “Ethics Consultation in U.S. Hospitals: A National Follow-Up Study, The American Journal of Bioethics, 22:4, 5-18, DOI: 10.1080/15265161.2021.1893547.  https://doi.org/10.1080/15265161.2021.1893547 .  However, while the article describes the prevalence of ethics review committees, it does not address their role as decisionmakers at the end of life.

[63] See http://www.empirestatebioethics.org . The author was a founding member of and a current director of the Empire State Bioethics Consortium, as well as a member of the ESBC team conducting the survey of ethics review committees.

[64] Institutional Review Boards, 21 Code of Federal Regulations Part 56, https://www.ecfr.gov/current/title-21/chapter-I/subchapter-A/part-56.

Robert N. Swidler

MA Binghamton University, JD Columbia Law School, and adjunct faculty at the Alden March Bioethics Center at Albany Medical College. Former General Counsel for St. Peter's Health Partners, past President of the NYS Bar Association Health Law Section, and served on the NYS Task Force on Life and the Law.

The author would like to acknowledge and thank Joseph J. Fins, MD, D Hum Litt, MACP, FRCP and Thaddeus T. Pope, JD, PhD, HEC-C. for their review of an early draft of this article, and their valuable comments.

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