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Enrollment/Change Form, Inc. & Affiliates P.O. Box 4058, Farmington, CT 06034-4058 www.connecticare.com 1-800-251-7722 Please print clearly, complete in full using ballpoint pen. EMPLOYEE: Complete
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What is ampamp?
ampamp stands for Advanced Medical Directive and Power of Attorney for Personal Care.
Who is required to file ampamp?
Individuals who want to appoint someone to make medical decisions on their behalf in the event they are unable to do so.
How to fill out ampamp?
ampamp forms can be filled out with the help of a lawyer or by following the instructions provided by the relevant legal authority.
What is the purpose of ampamp?
The purpose of ampamp is to ensure that an individual's medical wishes are respected and that someone is designated to make decisions on their behalf if they are unable to do so themselves.
What information must be reported on ampamp?
ampamp forms typically require information about the individual's medical preferences, designated decision-maker, and preferences for end-of-life care.
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