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PAT SENT INFORMATION FORM PLEASE PRINT CLEARLYTodays Date:Name:Date of Birth:Address:Your age:City:Marital Status:State:Gender:Email Address:Zip:SS#: Your occupation:Do you have a living will?: Yes
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How to fill out health care directives and

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How to fill out health care directives and

01
Here is a step-by-step guide on how to fill out health care directives:
02
Begin by obtaining the necessary forms. These forms are usually available online or can be obtained from your attorney or local hospital.
03
Read the instructions carefully. Make sure you understand the purpose and implications of the health care directives.
04
Start with the personal information section. Fill in your full name, address, phone number, and date of birth.
05
Designate a health care agent. This is the person who will make medical decisions on your behalf if you are unable to do so. Provide their name, contact information, and indicate your relationship with them.
06
Specify your preferences for medical treatments. Outline the types of treatments you would like to receive or refuse in various situations.
07
Indicate your wishes regarding organ donation and autopsy.
08
Consider adding any additional instructions or requests you may have.
09
Sign and date the document in the presence of witnesses. Most states require at least two witnesses who are not beneficiaries or potential beneficiaries of your estate.
10
Keep a copy of the completed health care directives for your records. Provide a copy to your health care agent, primary care physician, and any other relevant parties.
11
Review and update your health care directives regularly to reflect any changes in your wishes or circumstances.

Who needs health care directives and?

01
Health care directives are important for individuals who wish to have control over their medical decisions in case they become incapacitated.
02
Here are some examples of people who may benefit from having health care directives:
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- Elderly individuals who want to ensure their wishes are respected and followed as they age
04
- Individuals with chronic illnesses or terminal conditions who want to outline their preferences for end-of-life care
05
- Individuals who have strong beliefs or religious convictions that may impact their medical decisions
06
- Individuals who want to relieve their loved ones from the burden of making difficult medical decisions on their behalf
07
- Individuals involved in high-risk jobs or activities, such as military personnel or extreme sports enthusiasts
08
- Individuals who want to ensure their wishes regarding organ donation or autopsy are known and followed.
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Health care directives are legal documents that outline a person's wishes regarding their medical treatment and care if they become unable to make decisions for themselves.
Any adult individual can create and file health care directives to ensure their wishes are followed in case of incapacity.
Health care directives can be filled out with the assistance of an attorney or using online templates, and must be signed in the presence of witnesses.
The purpose of health care directives is to provide guidance to healthcare providers and family members when making medical decisions on behalf of an incapacitated individual.
Health care directives must include instructions on the use of life-sustaining treatments, preferences for end-of-life care, and the appointment of a healthcare proxy.
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