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FORM 15 Northwest Territories Mental Health Cancellation OF CERTIFICATE OF MENTAL INCOMPETENCE This cancellation indicates that the patient has been assessed by the attending medical practitioner,
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How to fill out cancellation of treatment decision

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How to fill out cancellation of treatment decision

01
Obtain the cancellation of treatment decision form from the healthcare facility.
02
Fill out your personal information including name, address, contact information, and date of birth.
03
Specify the treatment or procedure that you would like to cancel.
04
Provide a brief explanation for the reason behind the cancellation.
05
Sign and date the form to confirm your decision.
06
Ensure to follow any additional instructions provided on the form or by healthcare staff.

Who needs cancellation of treatment decision?

01
Anyone who has previously consented to a medical treatment or procedure but wishes to cancel it before it takes place.
02
Individuals who have changed their mind about undergoing a certain treatment and want to formally withdraw their consent.
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Cancellation of treatment decision is the process of revoking or withdrawing a previously made decision regarding a specific medical treatment or procedure.
The individual or the legal guardian of the individual who made the initial treatment decision is required to file the cancellation of treatment decision.
Cancellation of treatment decision can be filled out by completing the necessary form provided by the healthcare facility or provider and submitting it according to their specific requirements.
The purpose of cancellation of treatment decision is to ensure that individuals have the right to change their mind about medical treatments and procedures, and to communicate this change in decision to healthcare providers.
Cancellation of treatment decision must include the individual's name, date of birth, specific treatment or procedure being cancelled, date of cancellation, and signature of the individual or legal guardian.
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