Georgia Advance Directive For Health Care Form – A Georgia advance health care directive gives a person the right to choose a medical agent to make decisions on their behalf and choose end-of-life care options. This form allows for post-death decisions, such as requests for autopsy, organ donation, and final disposition of the body. This form does not need to be notarized and must be signed by two (2) witnesses
Signature Requirement (ยง 31-32-5(c)(1)(2)) – Two (2) witnesses of sound mind and at least 18 years of age. No witness can be the declarant’s agent or inherit or receive anything after the declarant’s death.
Georgia Advance Directive For Health Care Form
State Definitions (Section 31-32-2(1)) – “Health care appropriation”: defined by filer in Code 31-32-5. a written document prepared voluntarily according to the requirements of the section
How To Complete An Advance Directive
(1) The name is the principal or notifier of the patient who wishes to use this document to communicate with a physician in the State of Georgia. Your full name must be attached to this paper as your first submission
(3) Georgia Health Care Agent The director may appoint a Georgia health care agent (sometimes called a medical attorney) only by providing the appointee’s full name and contact information. Although the Georgia director can select almost anyone to serve under him, it is (strongly) recommended that the actual medical attorney be a trusted and reliable party to the director.
(5) Direct Contact Information It is essential that Georgia physicians be able to contact the attorney or health care agent with the information submitted. Thus, your current home phone number, work phone number, mobile phone number and email address must be registered.
(6) Name of first backup agent. The Georgia Health Care Agent designated at the time of this document may not always be available or qualified with a physician. A backup agent may be appointed to assume the responsibilities of an incapacitated or retired Georgia medical agent and to represent the director’s medical wishes. This is an optional appointment, but appointing a backup agent is a prudent precaution
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(9) Name of Second Support Agent An additional hiring option available through this form is a second support agent. If the actual medical attorney and first assistant agent are not available to represent the principal in Georgia, or the principal exercises authority to discuss and decide on the principal’s health care options with a physician in this state, revoke the commission. The second reserve agent named here may fulfill this role with the health authorities funded herein.
(11) Autopsy In addition to authorizing the director to speak with a Georgia physician on behalf of the patient, the Georgia director may authorize the medical officer to accept or deny a home autopsy. This type of authorization requires additional controls that come from the principal
(12) Organ and Body Donation By default, this document designates the Georgia Health Care Agent as the authority to determine the status of the director’s body after death. Georgia may limit this purpose by limiting the principal’s medical agent’s ability to donate the principal’s anatomical gifts to a medical study program and/or by limiting the principal’s donation of organs to the medical agent. not at all
(13) Final use of the body If the testator has a specific part in making the final decision about his body and burial, he must adopt this position through this document from the beginning of the power of attorney.
Ga End Of Life Documents
(14) Authorized disposal agent If the Georgia agent directs that a specific party must make the decisions and take the necessary actions to control the disposition of the body after death, that party shall be named. The qualifier’s address, telephone number and email address must also be documented
(15) Medical Conditions Triggering a Living Will The Georgia patient or declarant issuing this policy must specify that the living portion be administered in response to a predetermined medical condition. If the principal (or declarant) is terminally ill, death will occur regardless of treatment, unless he or she is permanently unconscious and incurable, or both, provided that the appropriate declaration or declarations are initiated.
(16) Treatment Options If the Georgia filer wants a health care provider to use this document to determine their medical needs, an instruction must be submitted. Georgia Declare may inform a participating health care provider that your life should be prolonged as long as possible, that you wish to die of natural causes, or that you do not want life-sustaining procedures to be performed in the usual way, but you agree to procedures listed in this policy beginning with statements A, B or C (as applicable) |
(17) Exceptions to natural death guidelines If the Georgia administrator decides that only certain end-of-life treatments will be withdrawn or denied in the C statement, the statement must provide additional authority to accurately assess the scope of treatment denials. The Georgia State Director may indicate that natural death is preferred, consent to receive food/water through a feeding tube, respiratory support with a ventilator (eg, intubation), and/or CPR. ) starting the appropriate instruction. Any combination of management permits under Statement C may be approved by the Georgia Commissioner.
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(18) Georgia Key Guidelines The Georgia registrant must ensure that this document accurately describes the treatment received or refused if the patient is persistently unconscious or terminally ill. For example, the Georgia Statement may require a time limit for withdrawal from treatment (eg, in case of permanent loss of consciousness, you must receive fluids or be ventilated for the duration of the examination). All these instructions can be delivered in the optional part. Note that instructions not included in this document or referenced by name and attached are not considered part of the document. Make sure all declared attachments are present when you sign
(19) Instructions During Pregnancy If Georgia is determined to be ill or permanently unconscious, additional approval will be required to terminate the pregnancy and initiate a Fetal Authorization Statement.
(20) Appointment of agent In addition to agents currently appointed in Georgia, the filer or principal may consider situations where a court has determined that a mortgage loan agent should be appointed as a custodian or custodian. Although the Georgia Declaration does not have the authority to appoint this party, it may appoint a medical agent or medical attorney to act as a court-appointed guardian or conservator by providing initial information. Marking paper
(21) Separate Designation If the Georgia filer elects that the court-appointed guardian or conservator be a domestic party other than his or her medical attorney-in-fact, Statement B must begin with the filer and include the name, address, telephone number ( s ) t, and the candidate’s email address must be documented
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(22) Effective date of appointment of chief health officer of the State of Georgia and II. the default effective date of the Part 1 declaration is the same calendar day on which the principal (or declarant) signs the document in front of two witnesses. To set a different date, you must provide letters from the Georgia administrator and submit the desired effective date.
(23) Termination Date or Event The Georgia issuing agent may also specify an expiration date for this instruction. Your Georgia power of attorney will remain in effect for life unless you revoke it.
(24) Stated by Georgia as Director A statement or signature of Director Georgia is required to establish this instruction as a valid representation of your physician’s instructions. It must be given according to the observation of two witnesses
(26) Signature of First Witness The authenticity of the signature provided by the Georgia Declaration must be verified. This requires two witnesses to agree to Georgia’s statement (or proxy) when signing this document. After the first witness discusses the declarant’s act of signing, he must read the statement and sign it himself.
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