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Accessibility Request Form Documents in Alternate Formats Personal Information (Please print) Name: ___ Address: ___ Home phone number: ___ Cell phone number: ___ Email address: ___Document Information
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How to fill out making a personal directive
How to fill out making a personal directive
01
Begin by choosing the person you want to appoint as your agent to make medical decisions on your behalf.
02
Make a list of your specific medical preferences and treatment options that you would like your agent to follow.
03
Specify any limitations or restrictions you want to place on your agent's decision-making authority.
04
Obtain the necessary forms for making a personal directive in your state and carefully fill them out with the information you have gathered.
05
Sign the personal directive in the presence of witnesses and have it notarized to make it legally binding.
06
Distribute copies of your personal directive to your agent, healthcare providers, and family members to ensure your wishes are known and followed.
Who needs making a personal directive?
01
Anyone who wants to ensure that their medical wishes are respected and followed in the event they are unable to make decisions for themselves.
02
People with specific healthcare preferences or concerns that they want to clearly communicate to their loved ones and healthcare providers.
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What is making a personal directive?
A personal directive is a legal document that allows an individual to appoint someone to make healthcare decisions on their behalf if they become incapacitated.
Who is required to file making a personal directive?
Any adult individual who wants to designate a decision-maker for healthcare decisions in case of incapacity is required to file a personal directive.
How to fill out making a personal directive?
To fill out a personal directive, an individual must clearly state their healthcare wishes and appoint a trusted person to act as their substitute decision-maker.
What is the purpose of making a personal directive?
The purpose of making a personal directive is to ensure that an individual's healthcare wishes are followed and that they have a designated decision-maker in case they are unable to make decisions for themselves.
What information must be reported on making a personal directive?
A personal directive must include the patient's healthcare wishes, the appointed substitute decision-maker, and any specific instructions for healthcare treatments.
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