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MY Humber Health Proxy Consent and Access Form 1235 Wilson Avenue, Toronto, ON M3M 0B2 Phone: 4162421000 ext. 82300 Fax: 4162421085MY Humber Health is a secure, online patient portal that connects

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How to fill out my humber health proxy

01

Obtain the Humber Health Proxy form from your healthcare provider or hospital.

02

Fill in your personal information including your name, address, and contact details.

03

Indicate who you are appointing as your health proxy and provide their contact information.

04

Specify any particular preferences or instructions for your health proxy to follow in your absence.

05

Sign and date the form in the presence of witnesses or a notary public.

06

Make copies of the completed form for yourself, your healthcare provider, and your appointed health proxy.

Who needs my humber health proxy?

01

Anyone who wants to ensure that their medical decisions are carried out according to their wishes if they become unable to communicate.

02

People with serious medical conditions or elderly individuals who may require someone to advocate for their healthcare needs.

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What is my humber health proxy?

A humber health proxy is a legal document that allows you to appoint someone to make healthcare decisions on your behalf if you are unable to do so yourself.

Who is required to file my humber health proxy?

Anyone who wants to ensure that their healthcare wishes are followed in the event that they are unable to communicate them.

How to fill out my humber health proxy?

You can fill out a humber health proxy by providing your healthcare agent's information and signing the document in the presence of witnesses.

What is the purpose of my humber health proxy?

The purpose of a humber health proxy is to ensure that your healthcare wishes are honored and that someone you trust can make medical decisions on your behalf.

What information must be reported on my humber health proxy?

Your humber health proxy should include the name and contact information of your healthcare agent, as well as any specific instructions or preferences you have regarding your medical treatment.

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