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[PDF] sample advance directive form

To the extent my wishes are unknown, my agent shall make health care decisions for me in accordance with what my agent determines to be my best interest In 
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[PDF] SAMPLE ADVANCE DIRECTIVES

If I cannot be expected to have a significant period of conscious life even after medical or surgical care, then I want comfort care only (Examples I do not want any surgery or other care designed to prolong my life I do not want artificially administered food or fluids and I do not want to be resuscitated )
advancedirectives


[PDF] Draft Advance Care Directive DIY Kit - YourSAy

the new draft Advance Care Directive form • extra information for witnesses, substitute decision-makers and interpreters The example statements have been  
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[PDF] Discussion Guide - Allina Health

help with advance care planning discussion or help in completing a health care directive, For example, you may want to have a priest, rabbi or pastor visit,
Health Care Directive discussion guide


[PDF] SAMPLE LANGUAGE FOR HEALTH CARE DIRECTIVES

Sample Language for Health Care Directives A My General View Regarding My Health Care • I have lived a good, long life I am not afraid to die If I am near 
Health Care Directives Sample Language


[PDF] 1 of 5 GENERAL INSTRUCTIONS: You can use this Advance

own Advance Directive you need to be very careful to ensure that it is consistent with North I DO want to receive ONLY artificial hydration (for example, through  
pdf Rex Advance Directive For A Natural Death


[PDF] Advance Directive Overview To complete this advance directive

values, and this advance directive with your health care agent(s) Unless you talk For example, you might need care to recover after surgery and you expect to 
Advance Directive






[PDF] Advance Directives - State of Michigan

For example, you can give your patient advocate power to consent to or refuse medical treatment for you; arrange for mental health treatment, home health care or 
Advance Directives


[PDF] Sample Text for a Handwritten Advance Directive - Credit Suisse

Sample Text for a Handwritten Advance Directive The Swiss child and adult protection law (KESR) allows a person with the capacity to act to determine
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Sample Advance Healthcare Directive

This is a sample advance directive. Advance directives vary by state and so it is important to fill out a state-specific advance directive form.



Advanced Health Care Directive Form

UNIFORM HEALTH CARE DECISIONS ACT [4670 - 4743] ( Part 2 added by Stats. 1999 Ch. 658



VIRGINIA ADVANCE DIRECTIVE FOR HEALTH CARE Section 1

this advance directive in case I am not able to make health care decisions for myself. This advance directive says what example if you were in the last.



a practical guide to psychiatric advance directives - SAMHSA

A psychiatric or mental health advance directive (PAD) is a legal tool Some examples of periods when a person may lack capacity include acute psychosis.



Advance Directives for Health Care

unable to make my own health care decisions as determined by the H) SIGNATURE: By writing this advance directive



Center for Clinical Standards and Quality/ Survey & Certification

Sep 27 2012 Examples of advance directives include: • Living will. • Directive to the attending physician. • Durable power of attorney for health care. • ...



Mississippi Advance Health-Care Directive

Mississippi Advance Health-Care Directive. Explanation. You have the right to give instructions about your own health care. You also have the.



VIRGINIA ADVANCE DIRECTIVE FOR HEALTH CARE

For example your health care agent is not legally required to pay your bills. updated April 2018. Page 9. 9 of 10. H. Life 



MINNESOTA STATUTE § 145C HEALTH CARE DIRECTIVE OF

Many medical treatments may be used to try to improve my medical condition or to prolong my life. Examples include artificial breathing by a machine connected 



Advanced Directives

guide includes information about advance directive forms with tips on how to use them. forms — a Health Care Proxy for example — which.

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