New york state health care proxy order form to order copies of the new york state health care proxy, please mail this form to: health care proxy nys department of health distribution center 21 simmons lane menands, ny 12204 these materials are...
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Patient and family guide to advance directives information on health care proxies and living wills member of the healthcare system 50611701 (8/04) introduction advances in modern medical care have not only saved lives, but have also improved the...
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Durable general power of attorney new york statutory short form the powers you grant below continue to be effective should you become disabled or incompetent (caution: this is an important document. it gives the person whom you designate (your...
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New york state health care proxy form 1. i, hereby appoint (name, home address and telephone number) as my health care agent to make any and all health care decisions for me, except to the extent that i state otherwise. this proxy shall take...
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Appointment of health care agent (tennessee) i, , give my agent named below permission to make health care decisions for me if i cannot make decisions for myself, including any health care decision that i could have made for myself if able. if my...
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Vermont advance directive for health care prepared by the vermont ethics network, july 2011 explanation & instructions you have the right to: 1. name someone else to make health care decisions for you when or if you are unable to make them...
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New jersey living will and health care surrogate declaration day of on this ,20 , i, (print name) of (mailing address) (city and state) (zip) social security number (phone) willfully and voluntarily make known my desire that my dying not be...
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