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Advance Care Plan Statement of Choices I understand that this Statement of Choices will be used to guide future medical decisions ONLY when I lose the ability to make or communicate medical treatment

How to fill out fremantle hospital acp statement

How to fill out Fremantle Hospital ACP statement:

1. Start by obtaining the Fremantle Hospital ACP statement form. This form can usually be obtained from the hospital's website or by asking the hospital staff.
2. Begin by providing your personal information in the designated sections of the form. This may include your name, address, contact details, and date of birth.
3. Next, fill in your medical history and any relevant medical conditions or allergies. It is important to be accurate and detailed in this section as it will help healthcare professionals understand your medical background.
4. In the section for treatment preferences, indicate your preferences for medical interventions, such as resuscitation, intubation, and life-sustaining treatments. You may choose to leave these decisions to your healthcare provider or provide specific instructions based on your personal values and beliefs.
5. Consider appointing a substitute decision-maker or medical enduring power of attorney. This individual will make decisions on your behalf if you are unable to do so yourself. Provide their contact information and discuss your wishes with them beforehand.
6. Discuss your ACP statement with your healthcare provider or doctor to ensure that it aligns with your current health condition and treatment goals.
7. Review the completed form for accuracy and completeness. Make sure all sections are filled out properly and that there are no errors or missing information.
8. Sign the ACP statement and have it witnessed according to the instructions provided on the form.
9. Keep a copy of the completed ACP statement for your records and provide a copy to your healthcare provider, substitute decision-maker, and any other relevant individuals or organizations.

Who needs Fremantle Hospital ACP statement?

1. Individuals who have specific treatment preferences they wish to communicate to healthcare providers in the event they become unable to make decisions for themselves.
2. Patients with significant medical conditions, especially those who may require life-sustaining treatments or interventions.
3. Individuals who want to ensure that their healthcare choices are respected and honored by healthcare professionals.
4. People who want to appoint a substitute decision-maker or medical enduring power of attorney to make decisions on their behalf.
5. Patients who wish to actively participate in their medical care and have a say in their treatment options.

Note: It is always recommended to consult with healthcare professionals or legal experts for specific advice related to filling out the Fremantle Hospital ACP statement, as requirements and procedures may vary.

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