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University of Pittsburgh Medical Center (UPMC) Adult Proxy Request Form What is Proxy? My UPMC includes a Proxy access feature, where on behalf of the patient, designated family members or other authorized

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What is upmc adult proxy request?

The UPMC adult proxy request is a form that allows an individual (the proxy) to make decisions on behalf of another adult who is unable to make decisions for themselves due to physical or mental incapacity.

Who is required to file upmc adult proxy request?

The individual who wishes to act as a proxy for an adult who is unable to make decisions for themselves is required to file the UPMC adult proxy request.

How to fill out upmc adult proxy request?

To fill out the UPMC adult proxy request, you must provide your personal information, including your name, contact information, and relationship to the adult for whom you will be serving as a proxy. You must also specify the specific decisions you are authorized to make on their behalf.

What is the purpose of upmc adult proxy request?

The purpose of the UPMC adult proxy request is to establish a legal framework for an individual to make decisions on behalf of an adult who is unable to make decisions for themselves due to physical or mental incapacity.

What information must be reported on upmc adult proxy request?

On the UPMC adult proxy request, you must report your name, contact information, and relationship to the adult. You must also specify the decisions you are authorized to make on their behalf.

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