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Instructions for the Electronic Transfer of Securities The Lewy Body Dementia Association cannot initiate transfers from your Broker Broker Instructions Wells Fargo Clearing Services, LLC (WFCS) Account
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01
Gather necessary personal information (name, address, date of birth).
02
Document medical history related to cognitive impairment and any previous diagnoses.
03
Include information about symptoms experienced (e.g., changes in memory, movement difficulties).
04
Provide details regarding any medications currently being taken.
05
Fill in family history of dementia or related neurological disorders.
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Specify any behavioral changes observed in daily life.
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Sign and date the form before submission.

Who needs form lewy body dementia?

01
Individuals suspected of having Lewy Body Dementia.
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Caregivers or family members of those with symptoms of Lewy Body Dementia.
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Healthcare professionals conducting assessments for cognitive disorders.
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Lewy body dementia is a type of progressive dementia that is characterized by the presence of abnormal protein deposits called Lewy bodies in the brain. It affects cognitive abilities, motor control, and can lead to hallucinations or sleep disturbances.
There is no specific 'form' associated with Lewy body dementia; rather, it is a medical diagnosis. Individuals diagnosed with Lewy body dementia or their caregivers may need to document their health status for healthcare purposes or financial support.
As there is no standard form specifically for Lewy body dementia, individuals should consult with healthcare professionals for documentation relevant to their situation, including medical history, symptoms, and treatment plans.
The purpose is not defined by a specific form; however, documenting the condition helps healthcare providers understand the patient's health needs and may be used for care planning, insurance claims, or legal matters.
If there were a form, it would likely require information such as the patient's full medical history, symptoms experienced, medications prescribed, functional ability, and any related health complications.
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