Health Care Proxy Form

Health Care Proxy Form. About the Health Care Proxy Form. Living Wills and the appointment of a person who can function as your health care proxy are important decisions we all should make related to how we wish to be treated as our life ends.

This Statement must be dated, and an examination must have taken place within. as my health care representative to make any and all health care decisions for me, including decisions to accept or to refuse any treatment, service or procedure used to diagnose or treat my physical or mental condition and decisions to provide, withhold or withdraw life-sustaining measures. You do this by completing the standard health care proxy form, noting the person you are designating to make. Health Care Quality Improvement Act Health Care Proxy Form Physical And Mental Health National Committee For Quality Assurance Public Key Cryptography.

The Massachusetts Health Care Proxy form can be downloaded and printed out here.

Carefully consider what powers you want to give your agent as you create your health care proxy.

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Health Care Quality Improvement Act Health Care Proxy Form Physical And Mental Health National Committee For Quality Assurance Public Key Cryptography. In some states the person who is authorized may be called a proxy, in others the person may be called an agent. Courtesy of new york state senator.