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FRENCH MARYLAND ADVANCE DIRECTIVE: PLANNING FOR FUTURE HEALTH CARE DECISIONS FORMULA IRE D INSTRUCTIONS DU MARYLAND POUR UN CHOIR ANTIC IPE DE SONS MEDIC AUX By: Date of Birth: (Print Name)

How to fill out using this advance directive

How to Fill Out Using This Advance Directive:

1. Obtain a copy of the advance directive form: Research the specific advance directive form required in your jurisdiction or healthcare facility. Obtain a copy of the form either online or by requesting it from the appropriate authorities.
2. Read and understand the instructions: Carefully read the instructions provided with the advance directive form. Understand the purpose, scope, and limitations of the document. Familiarize yourself with any legal or medical terminology used in the form.
3. Consult with healthcare professionals: If you have any questions or concerns about the advance directive, consult with healthcare professionals such as doctors, nurses, or social workers. They can provide guidance and clarify any uncertainties you may have.
4. Identify your healthcare agent: Select a trusted individual (known as a healthcare agent or proxy) who will make medical decisions on your behalf if you become incapacitated. Discuss your wishes and preferences with this person to ensure they understand your healthcare preferences.
5. Complete the personal information section: Provide your full legal name, contact information, and any other requested personal details in the designated section of the form.
6. Indicate your medical treatment preferences: In the advance directive form, specify your preferences regarding various medical treatments, interventions, and life-sustaining measures. Clearly state whether you wish to receive or refuse specific treatments such as cardiopulmonary resuscitation (CPR), mechanical ventilation, artificial nutrition, or hydration.
7. Consider end-of-life care and instructions: If desired, express any specific end-of-life care instructions, such as your preferences for pain management, palliative care, or hospice care. You may also include details about organ donation or autopsy authorization.
8. Sign and date the form: Once you have completed the advance directive form, sign and date it in the presence of witnesses or a notary public, as required by law. Follow any specific witnessing or notarization requirements mentioned on the form.

Who Needs Using This Advance Directive:

1. Individuals of legal age: Advance directives are typically applicable to individuals who have reached the legal age of majority, which may vary among jurisdictions. Consult the laws and regulations of your specific area to determine whether you are eligible to complete an advance directive.
2. Individuals with capacity limitations: Advance directives are particularly important for individuals who may have diminished mental capacity or those suffering from chronic illnesses that could eventually result in incapacitation. By completing an advance directive, these individuals ensure that their healthcare preferences are known and respected.
3. Those wishing to exercise autonomy in medical decision-making: Advance directives are designed to empower individuals as they have the right to make decisions about their own medical care. Through an advance directive, individuals can maintain control over their treatment preferences even if they become unable to communicate or make decisions.

Note: It is crucial to consult legal advice or healthcare professionals to ensure compliance with local laws and regulations when completing an advance directive.

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What is using this advance directive?

This advance directive is used for making healthcare decisions in advance.

Who is required to file using this advance directive?

Any individual who wants to plan ahead for their medical care.

How to fill out using this advance directive?

The advance directive can be filled out with the help of a healthcare provider or legal advisor.

What is the purpose of using this advance directive?

The purpose is to ensure that an individual's wishes regarding medical treatment are known and respected in case they are unable to communicate.

What information must be reported on using this advance directive?

The advance directive typically includes the individual's healthcare preferences, healthcare proxy, and any specific instructions for treatment.