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STATE OF CALIFORNIA PUBLIC EMPLOYMENT RELATIONS BOARDUNFAIR PRACTICE CHARGE DO NOT WRITE IN THIS SPACE:Case No:Date Filed:INSTRUCTIONS: File the original and one copy of this charge form in the appropriate
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Do not write in is a legal document used to declare someone's wishes regarding their end-of-life medical treatment.
Any individual who wants to make their end-of-life medical preferences known is required to file a do not write in form.
To fill out a do not write in form, one must carefully consider their medical treatment preferences and clearly document them on the form.
The purpose of do not write in is to ensure that an individual's end-of-life medical wishes are respected and followed.
The do not write in form must include information about the individual's preferred medical treatments, resuscitation preferences, and designated healthcare proxy.
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