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COMMUNICATION AND TREATMENT PREFERENCE ASSESSMENT This assessment tool will enhance the partnership between you and the ALS Clinic Team and will help us to better understand your treatment preferences.
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How to fill out communication and treatment preference

01
To fill out the communication and treatment preference form, follow these steps:
02
Obtain the form from a healthcare provider or download it from their website.
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Read the instructions on the form carefully to understand what information is required.
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Start by providing your personal details, such as your name, date of birth, and contact information.
05
Specify your communication preferences, such as whether you prefer to communicate verbally, through sign language, or in writing.
06
Indicate your treatment preferences, including your choices regarding life-sustaining treatments and end-of-life care.
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If there are any specific instructions or additional preferences you have, provide them in the designated section.
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Review the completed form to ensure all information is accurate and complete.
09
Sign and date the form before submitting it to your healthcare provider.
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Keep a copy of the filled out form for your records.
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Remember to update your communication and treatment preferences if they change in the future.

Who needs communication and treatment preference?

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Communication and treatment preference forms are beneficial for anyone who wants to proactively communicate their preferences regarding medical care and treatment.
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This includes people of all ages and health conditions, especially those with chronic illnesses, terminal conditions, or a high risk of medical emergencies.
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It is also essential for individuals who want to ensure that their healthcare decisions align with their personal values and beliefs.
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Everyone should consider filling out these forms to have their preferences known and respected by healthcare providers and loved ones during times when they may not be able to communicate their wishes.
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Communication and treatment preference refers to the specific instructions or preferences individuals have regarding how they wish to communicate and be treated in certain situations, particularly related to their medical care.
Individuals are required to file communication and treatment preference, especially when creating advance directives or medical power of attorney documents.
Communication and treatment preferences can be filled out by completing specific forms provided by healthcare facilities or legal professionals. It is important to clearly outline preferences related to communication, treatment options, and decision-making authority.
The purpose of communication and treatment preference is to ensure that individuals' wishes and preferences regarding their medical care are known and honored, particularly in situations where they may not be able to communicate or make decisions for themselves.
Communication and treatment preference forms typically include information such as preferred methods of communication, specific treatments or interventions desired or refused, and the designation of a healthcare proxy or decision-maker.
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