HI DoH Advance Health Care Directive Form 2003-2025 free printable template
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ADVANCE HEALTH CARE DIRECTIVE FORM Date: Your Name: Last First City Street Address Middle initial State Zip Part 1: INDIVIDUAL INSTRUCTIONS FOR HEALTH CARE The following statements only apply ? If
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How to fill out hawaii advance health care directive form
How to fill out HI DoH Advance Health Care Directive Form
01
Obtain the HI DoH Advance Health Care Directive Form from the official website or local health department.
02
Read the instructions carefully to understand the purpose of the form.
03
Fill in your personal information at the top of the form, such as your name, address, and date of birth.
04
Designate a health care agent by writing their name and contact information, ensuring they are trustworthy and willing to advocate for your wishes.
05
Outline your medical treatment preferences by selecting options for life-sustaining treatments, organ donation, and other health care decisions.
06
Discuss your preferences with your health care agent and ensure they understand your wishes.
07
Review the completed form for accuracy and completeness.
08
Sign and date the form in the presence of a witness who is not related to you or your health care agent.
09
Make copies of the signed form for your records and provide a copy to your health care agent and health care providers.
Who needs HI DoH Advance Health Care Directive Form?
01
Anyone who wants to ensure their health care wishes are respected in case they are unable to communicate.
02
Individuals with specific medical conditions or those approaching end-of-life situations.
03
People who wish to designate a health care agent to make decisions on their behalf.
04
Adults looking to exercise their right to dictate their health care preferences.
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What is HI DoH Advance Health Care Directive Form?
The HI DoH Advance Health Care Directive Form is a legal document that allows individuals to specify their preferences for medical treatment and appoint a healthcare agent to make decisions on their behalf in case they become unable to communicate or make decisions for themselves.
Who is required to file HI DoH Advance Health Care Directive Form?
Any adult resident of Hawaii who wishes to outline their healthcare preferences or appoint a healthcare agent is encouraged to fill out the HI DoH Advance Health Care Directive Form, although it is not legally required.
How to fill out HI DoH Advance Health Care Directive Form?
To fill out the HI DoH Advance Health Care Directive Form, individuals should read the instructions carefully, specify their healthcare wishes, appoint a healthcare agent if desired, sign the document in the presence of witnesses, and ensure that copies are provided to relevant parties.
What is the purpose of HI DoH Advance Health Care Directive Form?
The purpose of the HI DoH Advance Health Care Directive Form is to ensure that a person's healthcare preferences are known and followed when they are unable to make decisions for themselves, providing clarity and guidance to medical professionals and family members.
What information must be reported on HI DoH Advance Health Care Directive Form?
The HI DoH Advance Health Care Directive Form must include the individual's name, healthcare agent's name and contact information, specific medical treatment preferences, wishes regarding life-sustaining treatment, and signatures from the individual and witnesses.
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