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AFFIX IDENTIFICATION LABEL HEREResidential Aged Care Facility. R. NUMBER: ___GOALS OF CARE Medical Treatment OrdersSURNAME: ___Facility.GIVEN NAME: ___Address DATE OF BIRTH: ___/___/___ SEX: ___TO

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How to fill out statement of choices form

01

Obtain a blank statement of choices form from the appropriate institution or organization.

02

Fill in your personal information such as name, address, contact information, etc.

03

Select the choices or options provided on the form that are applicable to your situation.

04

Provide any additional information or documentation requested on the form.

05

Review the completed form for accuracy and completeness.

06

Sign and date the form as required.

07

Submit the completed form to the designated recipient according to the instructions provided.

Who needs statement of choices form?

01

Individuals who are making decisions about their preferences or choices related to a specific matter or situation.

02

Institutions or organizations that require individuals to formally declare their choices or preferences.

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What is statement of choices form?

The statement of choices form is a document that allows individuals to indicate their preferences or selections.

Who is required to file statement of choices form?

Individuals who need to make decisions or choices related to a certain matter are required to file a statement of choices form.

How to fill out statement of choices form?

To fill out a statement of choices form, one must carefully read the instructions provided and clearly indicate their selections or preferences.

What is the purpose of statement of choices form?

The purpose of the statement of choices form is to record and formalize an individual's choices or preferences for future reference.

What information must be reported on statement of choices form?

The information reported on a statement of choices form typically includes the individual's name, choices/options available, and any necessary signatures or dates.

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