HEALTH CARE DIRECTIVE
HEALTH CARE DIRECTIVE
|You |
|Do you wish to donate your organs, tissues and other body parts after your death? |
|yes no |
|Do you wish to donate your remains to science as an anatomical gift for the purposes of teaching health care professionals after your |
|death? yes no |
|Do you wish to be buried cremated |
|Any special instructions? ____________________________________________________ |
|If not required by law, do you wish to have a post mortem examination (autopsy) performed for the purposes of diagnosis, medical education|
|and research? yes no |
|Do you wish to give your power of attorney power to override your decision to donate your organs? yes no |
|Spouse |
|Do you wish to donate your organs, tissues and other body parts after your death? |
|yes no |
|Do you wish to donate your remains to science as an anatomical gift for the purposes of teaching health care professionals after your |
|death? yes no |
|Do you wish to be buried cremated |
|Any special instructions? ____________________________________________________ |
|If not required by law, do you wish to have a post mortem examination (autopsy) performed for the purposes of diagnosis, medical education|
|and research? yes no |
|Do you wish to give your power of attorney power to override your decision to donate your organs? yes no |
|POWER OF ATTORNEY FOR THE HEALTH CARE DIRECTIVE |
|You |
|To grant to the attorney-in-fact any of the following powers, make a check or "x" on the line in front of each power being granted. |
|real property transactions; I choose to limit this power to real property: _________________________________________________ |
|tangible personal property transactions; |
|bond, share, and commodity transactions; |
|banking transactions; |
|business operating transactions; |
|insurance transactions; |
|beneficiary transactions; |
|gift transactions; |
|fiduciary transactions; |
|claims and litigation; |
|family maintenance; |
|benefits from military service; |
|records, reports, and statements; |
|all of the powers listed in (A) through (M) above and all other matters. |
|2. Should the Power of Attorney continue if you become incapacitated or incompetent? |
|yes no |
|Should this Power of Attorney authorize the attorney-in-fact to transfer property to the attorney-in-fact? yes no |
|Unless you request it, does your attorney-in-fact need to render accounting to you or your estate? yes no |
|Spouse |
|To grant to the attorney-in-fact any of the following powers, make a check or "x" on the line in front of each power being granted. |
|real property transactions; I choose to limit this power to real property: _________________________________________________ |
|tangible personal property transactions; |
|bond, share, and commodity transactions; |
|banking transactions; |
|business operating transactions; |
|insurance transactions; |
|beneficiary transactions; |
|gift transactions; |
|fiduciary transactions; |
|claims and litigation; |
|family maintenance; |
|benefits from military service; |
|records, reports, and statements; |
|all of the powers listed in (A) through (M) above and all other matters. |
|2. Should the Power of Attorney continue if you become incapacitated or incompetent? |
|yes no |
|Should this Power of Attorney authorize the attorney-in-fact to transfer property to the attorney-in-fact? yes no |
|Unless you request it, does your attorney-in-fact need to render accounting to you or your estate? yes no |
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- organ
- home nottinghamshire county council
- you never know when you or someone close to you will need
- health care directive
- how to donate your body for medical science
- donor application packet
- bequest booklet for web and email 8 13
- virginia department of health
- practicing medical procedures on the newly dead u s
Related searches
- ancient health care methods
- united health care premium payment
- nevada bureau of health care compliance
- argumentative health care topics
- health care persuasive speech topics
- adventist health care system jobs
- home health care jobs hiring
- home health care jobs near me
- hiring home health care aides
- united health care make a payment
- health care worker registry illinois
- free health care argumentative essays