PDF-Advance Health Care Directive Form InstructionsYou have the right to g

PSXMHS442 Rev 304 You can write down your wishes about donating your bodily organs and tissues following your death You can select a physician to have primary or main Part 5 Signature and Wit. It can control critical decisions about your health care Before signing consider these important facts Facts About PART B Appointing a Health Care Representative You have the right to name a person to direct your health care when you cannot do so Th Training Outline . Learning Objectives. Staff Responsibilities. Deciding Whether to Complete a VA Advance Directive,. a . State-Authorized Advance Directive, or Both. Appointing a Health Care Agent. Information For Consumers. West Virginia Mental Health Planning Council. This information was developed to raise awareness of Psychiatric Advance Directives. It is not intended to provide legal or medical advice.. Training Outline . Learning Objectives. Staff Responsibilities. Deciding Whether to Complete a VA Advance Directive,. a . State-Authorized Advance Directive, or Both. Appointing a Health Care Agent. Introduction to Advance . Directive for Health Care. In 2004, the Health Care Decision Act was passed thus revising Tennessee law concerning health care decision making. What does the . Act do. ? . DIRECTIVES,. GOALS OF CARE CONVERSATIONS AND LIFE-SUSTAINING TREATMENT . DECISIONS,. STATE-AUTHORIZED PORTABLE . ORDERS. HOW DO . THESE . PIECES FIT . TOGETHER. . TO ELICIT AND DOCUMENT PATIENT TREATMENT PREFERENCES? . ADVANCE HEALTH CARE DIRECTIVE FORMPAGE 2 of 7home phone work phonePART 1 POWER OF ATTORNEY FOR HEALTH CARE11 DESIGNATION OF AGENT I designate the following individual as my agent to make Advance Directives . are instructions created by an individual to administer, withhold, or withdraw life-sustaining procedures in the event of a terminal or irreversible condition . These instructions explain the individuals wishes for health care in the event they become incompetent or otherwise mentally/physically incapable of communication. Only 25% of Americans…. have . put their medical care wishes in writing.. Anna’s story. Anna’s experience. Advance care planning. Facing the unexpected. Family members disagree. Finding an advance healthcare directive. What is Advance Care Planning. It is a regulatory requirement that we inquire about the presence of an Advance Directive and offer assistance in completing one for each inpatient admission.. At CMC, we are dedicated to providing assistance with the documentation, storage, retrieval, and honoring of patients’ advance care planning as it is essential for providing quality that reflects the goals and values of our patients.. This is the Health Care Directive of: Name Address Province Telephone Part 1 – Designation of a Health Care Proxy You may name one or more persons who will have the power to make decisions abo Indianapolis, Indiana 46204 March 1999 Revised May 2004 Revised Ju ly 1, 2013 _______________________________________________________________________________ ADVANCE DIRECTIVES YOUR RIGHT TO DECIDE _ As a VA patient you have a say in the health care you receive. Normally your doctor explains your WHAT YOU SHOULD KNOW ABOUT ADVANCE DIRECTIVES CONTINUED Your advance directive is used only when you ACP training session 3 for all staff. INSERT FACILITY NAME HERE . Learning outcomes. After completing this session, you should be able to:. List the three advance care planning documents that are commonly used in Queensland.