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PLACE PATIENT LABEL HERE Authorization for Third Party Access to My Clink Account ADULT WITH DIMINISHED CAPACITY This form is being completed by an adult who is responsible for health care decisions
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Adult with diminished capacity refers to individuals who may have impairments in decision-making abilities or cognitive functions.
The legal guardian or authorized representative of the adult with diminished capacity is required to file on their behalf.
To fill out adult with diminished capacity, the guardian or authorized representative must provide detailed information about the individual's impairments and needs.
The purpose of filing adult with diminished capacity is to ensure that the individual receives appropriate care and support based on their specific needs.
Information such as medical history, cognitive assessments, and care options must be reported on adult with diminished capacity.
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