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FILLING OUT AN AD
STEP BY STEP
It is never too early to begin the
process. Here are some tips to get you started:
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Pick up the form from
your lawyer, hospital, or state attorney general’s office. You do
not need a lawyer for an AD to be legally valid. You can also
pick up an inexpensive AD form from the California Coalition for
Compassionate Care. Go here for more information
for obtaining forms. |
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Fill out the form exactly as
instructed. You need either two
adults witnessing your signing of the AD or a notary public must
witness the signing.
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The witnesses may not include your agent,
your physician (or an employee of the health care provider.) |
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Also, at
least one of the witnesses cannot be related to you by blood
marriage or adoption, or be named in your will. |
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If using a
notary public, you
may need to present proof of your identity, something with your
picture on it – a recent driver’s license or U.S. passport. |
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Choose an agent (also called an
attorney – in – fact):
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You can choose almost anyone
over the age of 18 to be your agent. If you appoint your
spouse and you later divorce, the DPAHC may automatically be
invalid. |
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If you can’t make your own
decisions, your agent must make them consistent with wishes
you have written in the DPAHC. Depending on the state in
which you live, your agent may not be able to make decisions
such as mental health treatment, psycho – surgery,
sterilization, or abortion. |
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In case your primary agent is
unavailable, appointing an alternate agent is a good idea. |
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Make several copies and
give them to family members and your doctor. |
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An AD remains
valid until you revoke it or until your death.
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