About the Health Care Proxy Form This is an important legal document. The New York health care proxy you appoint an Agent, or Surrogate, who is in charge of directing your medical care. Read more about the Health Care Proxy. NEW YORK HEALTH CARE PROXY AND . Health Care Proxy. 0000035995 00000 n The New York legislature has created a medical or healthcare power of attorney form. (a) The health care proxy shall: (i) identify the principal and agent; and (ii) indicate that the principal intends the agent to have authority to make health care decisions on the principal's behalf. Once your Health Care Proxy has been signed, it's important to ensure that a copy is given to your agent, primary care physician and other family members. Health History Questionnaire. Found insideHospital Association of New York State. and Health Care Proxy proposals . The surrogate bill is designed to provide a process for obtaining consent to ... New York Health Care Proxy Item (1) Write the name, home address and telephone number of the person you are selecting as your agent. Proxy Servers from Fineproxy - High-Quality Proxy Servers Are Just What You Need. These materials are available free of charge to New York State residents and organizations. New York Medical Power of Attorney (Health Care Proxy) In New York State, a health care/medical power of attorney form is called a New York health care proxy. 0000002221 00000 n Interweaving evocative stories of Puri's family and the patients she cares for, That Good Night is a stunning meditation on impermanence and the role of medicine in helping us to live and die well, arming readers with information that will ... Found inside – Page 51New York's health care proxy law permits adults to grant an agent the authority to make some or all treatment decisions , including decisions about life ... 0000012559 00000 n 0000038251 00000 n Chinese Health Care Proxy Author: New York State Department of Health Subject: New York State's health care proxy written in Chinese Keywords: health care, proxy, chinese Created Date: 2/11/2002 3:52:29 PM Part II. 0000013393 00000 n The most secure digital platform to get legally binding, electronically signed documents in just a few seconds. 0000003479 00000 n Fill out, securely sign, print or email your nys health care proxy instantly with signNow. 0 0000009488 00000 n A Health Care Proxy form, established under New York law, allows you to appoint someone you trust—a Health Care Agent—to make health care decisions on your behalf if you are no longer able to do so.2 You can tell your wishes to your agent orally or in writing . Read more about the Health Care Proxy. Found inside – Page 356Memorandum of Senator James J. Lack 1994.367 Statutory Short Forms of Power of Attorney Chapter 499 S.4757 - A Lack A.10754 Rules Amends $ 95-1501 , 5-15020 ... Fill out, securely sign, print or email your health care proxy form 2010-2020 instantly with SignNow. 201 0 obj <>stream startxref New York State Living Will Health Care Proxy Forms - A living will form free printable is a document that explains what kinds of treatment as well as therapy you intend to get when you're not capable to speak about it. Found inside – Page 415... however, the New York legislature has enacted only a statute permitting individuals to designate a “proxy” to make their health care decisions if they ... This Health Care Proxy shall take effect in the event I become unable to make my own health care decisions. FHCDA applies in hospitals and nursing homes only. Your agent should know what you Before signing, you should understand that: 1. NYS Advance Directive Forms & Documents. New York Health Care Proxy Forms (provided by the NYS Department of Health). Found inside – Page 34distributed to adult patients at hospitals , nursing homes and mental health facilities under the terms of the health care proxy law in New York State ... This form gives the person you choose as your agent the authority to make all health care Therefore it is vital that he or she share your views and philosophies as to critical medical issues in relation to end of life treatment options. 39. A health care proxy is someone you appoint to make medical decisions and give informed consent on your behalf in the event you lose the ability to do so. 0000037169 00000 n 0000037788 00000 n Diversity, Inclusion and Elimination of Bias CLE Programs, Torts, Insurance and Compensation Law Section, Committee for Bar Leaders of New York State, Committee on Civil Practice Laws and Rules (CPLR), Committee on Communications and Publications, Committee on Courts of Appellate Jurisdiction, Committee on Legal Education and Admission to the Bar, Committee on Procedures for Judicial Discipline, Committee on Standards of Attorney Conduct, Committee on Technology and the Legal Profession, Committee on the New York State Constitution, President's Committee on Access to Justice, Special Committee on Association Structure and Operations, Special Committee on Strategic Communications, Task Force on Autonomous Vehicles and the Law, Task Force on Domestic Terrorism and Hate Crimes, Task Force on Free Expression in the Digital Age, Task Force on Incarceration Release Planning and Programs, Task Force on Mass Shootings and Assault Weapons, Task Force on the Evaluation of Candidates for Election to Judicial Office, Task Force on the New York Bar Examination, Probate and Administration of Decedents Estate, Commercial & Federal Litigation Section Newsletter, Torts, Insurance and Compensation Law Journal, Trusts and Estates Law Section Newsletter, Marketing Your Practice - Attorney Advertising, Business Development and Ethics, Selling Your Practice, Closing and Retirement, Resources on Professional Standards for Attorneys, Alcohol Use Disorder & Substance Use Disorders, MCLE Rules for Attorneys: Earning CLE Credit for Mock Trial, NYS Mock Trial 101 Program Training Video, Judicial Nominations – Resources for Local and County Bar Associations, New York State Department of Health Web site. Unless I revoke it, this proxy shall remain in effect indefinitely or untilas my health care agent to make any and all health care decisions for me,He or she signed (or asked another to sign for him or her) this documentappears to execute this proxy willingly and of his or her own free willIf the person I appoint is unable, unwilling or . New York Health Care Proxy Law. In a health care proxy, the principal can describe what medical actions should be taken in the event of a severe illness or incapacitation. But before you designate any person, make sure you discuss this choice with them and that they understand and are comfortable carrying out your wishes. Discusses the flaws and corruption in the funeral and burial industry in the United States, from exorbitant funeral costs to black market sales of body parts, and provides legal guidelines to burial rights and trends in legal reform. Please contact the plan for further details. 0000036683 00000 n These forms are also known as advance health care directives. 0000036780 00000 n Found inside – Page 42A high level of responsibility is inherent in drafting directives . ... The 1991 health care proxy statute predates article 81 of the MHL and refers to ... HEALTH CARE DECISIONS [4600 - 4806] ( Division 4.7 added by Stats. Health Care Proxy Form Designates Health Care Agent. la atención médica) Cómo designar a su apoderado para la atención médica en el estado de Nueva York . Originals or photocopies may be given to your physician, your health care agent, your alternate agent, your attorney or other advisor, close family members, and, of course, one for yourself. View the NYS Patients' Bill of Rights. Areas of focus for the workshop include the clinical rationale behind collecting these data, standardized questions that can be used to collect these data, mechanisms for supporting providers and patients in the collection of these data, ... Health Care Proxy Form. Introduction to Your New York Health Care Proxy and Living Will This packet contains a legal document, a New York Health Care Proxy and Living Will, that protects your right to refuse medical treatment you do not want, or to request treatment you do want, in the event you lose the ability to make decisions yourself. Get free copies of materials. h�b```b`0v��� �� You can get a copy of the New York State Health Care Proxy Form in multiple languages online or by phone. They are also called a health care agent, proxy, or surrogate. LIVING WILL - PAGE 3 OF 6 . 2021 Health Care Proxy Form - Fillable, Printable PDF & Forms | Handypdf. 0000018281 00000 n Living Will . The New York medical power of attorney, also known legally as a 'health care proxy' document, gives the patient the right to an appointed agent should they be suffering from an illness which causes them to become incapacitated. Item (2) (nourishment If you want to appoint an alternate agent, write the name, home address and telephone number of the person you are selecting as your alternate agent. 0000018553 00000 n In most cases, your health care documents will be honored in other states. New York State Health Care Proxy ORDER FORM To order copies of the New York State Health Care Proxy, please e-mail this form to: b0019w@health.ny.gov Or mail to: PO Box 343 Guilderland NY 12084-0343 . A Health Care Proxy is a legal document in New York state which allows you to appoint someone to make health care decisions on your behalf if you lose the ability to make decisions for yourself.. New York state provides a standard form in the law. Living Will vs. Do Not Resuscitate (DNR) vs. MOLST. 140 0 obj <> endobj Found inside – Page 42You can get a sample form with instructions by writing to the New York ... (while you still can) by appointing a health-care proxy to make decisions for you ... 0000000016 00000 n trailer Under New York State law you can appoint a particular individual as your health care "agent" or "proxy". The New York Health Care Proxy Law allows people over age 18 to appoint someone they trust - for example, a family member or close friend (but not their own treating physician) -- as their "health care agent" to make health care decisions for them if they lose the ability to make decisions themselves. 326 0 obj <> endobj 333 0 obj <>/Filter/FlateDecode/ID[]/Index[326 16]/Info 325 0 R/Length 57/Prev 324821/Root 327 0 R/Size 342/Type/XRef/W[1 2 1]>>stream Once your Health Care Proxy has been signed, it's important to ensure that a copy is given to your agent, primary care physician and other family members. Give your Health Care Proxy Form to your medical providers. Educational Resources. FHCDA is based on the 1992 Task Force report. There are many types of advance directive documents. General Forms, Documents, and Resources. This person is called a health care agent. (3) Name of substitute or fill-in agent if the person I appoint above is These forms are free and provided as a service to all New Yorkers. %%EOF Off the Mask - Friday, September 10, 2021. 2010 - Family Health Care Decisions Act (FHCDA) is passed by the Legislature and signed by Governor Paterson, creating surrogacy laws in NYS. MOLST becomes a NYSDOH Form (Form DOH-5003). Please allow at least three weeks for delivery. NEW YORK HEALTH CARE PROXY AND . 0000005279 00000 n This is titled Health Care Proxy and may be found in the New York Consolidated Laws, Public Health Law, Section 2981. A Health Care Proxy Guide for New York. 0000011827 00000 n Health care proxyappointing your health care agent in new york stateplease note: this document is also available in spanish.to order, call patient/health education at (718) 920-6058.policy statement: montefiore medical center recognizes a patient's Found inside – Page 56Proxy directives designate a surrogate decisionmaker . ... on Uniform State Laws of the Uniform Health - Care Decisions Act will give strong support for the ... 0000003642 00000 n 0000011871 00000 n You do this by completing the standard health care proxy form, noting the person you are designating to make . New York Health Care Proxy Item (1) Write the name, home address and telephone number of the person you are selecting as your agent. (b) The health care proxy may include the principal's wishes or instructions about health care . This authority also includes the decisions regarding end of life treatment. "Health care" means any treatment . Found inside – Page 162Physician , whose mental health care facilities , and does not hospital ... and thus statute could complaint with New York's Public Health not form basis of ... 0000009238 00000 n A New York medical power of attorney, or 'health care proxy', grants an individual the right to represent another person's medical-related interests.Such a delegation of power can be made pursuant to Article 29-C of the Public Health Law.To be more specific, this statute allows the appointment of a health care agent who will be tasked with making health decisions on the individual's . Found inside – Page 2A Newsletter Published by the NYS Commission on Quality of Care for the Mentally ... At the SDMC The health care proxy form , to should be informed . Online. Edit, fill, sign, download New York State Health Care Proxy Form online on Handypdf.com. 0000036198 00000 n Also, you can sign, fax and print it from PC, iPad, tablet or mobile! Available for PC, iOS and Android. 0000004432 00000 n This Living Will has been prepared to conform to the law in the State of New York, and is intended to be "clear and convincing" evidence of my wishes regarding the health care decisions I have indicated below. Found inside – Page 11-6For example , New York enacted its Health Care Proxy Act in 1991 , which sets forth , inter alia , a sample health care proxy form . 6:00 PM. Wednesday, October 21, 2020. You would essentially designate a power of attorney, or a healthcare surrogate . Be sure to include current phone numbers for your health care agent and alternate so they can be contacted in an emergency.New York Health Care Proxy Forms (provided by the NYS Department of Health). �,�%�000~d�ap`S`��F��EQ�����"C���#�^�OV�5s��:z�pV ���r|k���0b�h``b����- Z/��xAH���A�x�%����x��)����� ��lR�L��@\����~��;��@���uճo��� �ˠ��r�H3 ��{Y����C ��_ ? Found insideA contemporary exploration of death and dying by a young Duke Fellow who investigates the hows, whys, wheres, and whens of modern death and their cultural significance. In New York State, a health care proxy form (HCP) is the preferred advance directive. This entry was posted on May 2, 2016. A health care proxy is a document created by an individual (the principal) which names another person as their health care agent to have the authority to make health care decisions if and when the principal is determined to be incapable of making medical care decisions for themselves. Item (3) Your Health Care Proxy will . Patients' Bill of Rights. View the NYS Patients' Bill of Rights. You may designate any competent adult to be your agent and alternate agent. Just imagine that 1000 or 100 000 IPs are at your disposal. 0000009378 00000 n (2) Optional instructions: I direct my agent to make health care decisions in accord with my wishes and limitations as stated below, or as he or she otherwise knows. 0000038278 00000 n The New York State Health Care Proxy Form is an important legal document. This Living Will has been prepared to conform to the law in the State of New York, and is intended to be "clear and convincing" evidence of my wishes regarding the health care decisions I have indicated below. Usually, it will be. Health Care Proxy is the written document that designates a person as your health care agent when a . The New York Health Care Proxy Law allows an individual to appoint someone, for example, a family member or close friend, to make healthcare decisions on their behalf if they lose the ability to make decisions themselves. This is a New York form and can be use in Power Of Attorney Legal Forms. Sample Healthcare Proxy Form - Massachusetts. Instructions on Health Care Proxy This is an important legal form. 0000004861 00000 n Health Care Proxy. Found inside – Page 533 Appendix III : Durable General Power of Attorney Effective at a Future Time : New York Statutory Short Form 37 Appendix IV : Health Care Proxy . Under New York's Family Health Care Decisions Act, if you have not signed a health care proxy form and you become mentally incapacitated, health care decisions while you are in a hospital or residential care facility can be made for you by an individual called a "surrogate." (The rules with regard to who can serve as a surrogate and what . The Family Health Care Decisions Act (FHCDA) of 2010 allows family members or a close friend (if there are no family members) to act as a "surrogate" or representative of the patient to make health care decisions, including withholding or withdrawing of life-sustaining treatment, for a patient who loses the ability to make those decisions when the patient has not signed a health care proxy. Contents and form of health care proxy. Included here are valuable guidelines, compassionate suggestions, and a simple-to-use workbook section that together offer support to free the patient from worry and the caregivers from burnout. <<0346CC487EFD1948AA0F29DB701BA811>]>> Appointing a Health Care Agent in New York State. 0000004577 00000 n Just imagine that 1000 or 100 000 IPs are at your disposal. Bringing a diverse range of disciplines into conversation for the first time, Are We Born Racist? offers a straightforward overview of the new science of prejudice, and showcases the abundant practical, research-based steps that can be ... 658, Sec. 2011 - FHCDA is updated to also apply to hospice. This book explores two case studies that illustrate the application of the guidance and principles laid out in the report. One scenario focuses on a gradual-onset pandemic flu. Fill Out and Sign Nys Health Care Proxy Form . Printable and fillable New York State Health Care Proxy Form endstream endobj 327 0 obj /Filter<>/PubSec<>>>/Reference[<>/Type/SigRef>>]/SubFilter/adbe.pkcs7.detached/Type/Sig>>>>/StructTreeRoot 89 0 R/Type/Catalog/ViewerPreferences<>>> endobj 328 0 obj <>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/StructParents 136/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 329 0 obj <>stream ADVANCE HEALTH CARE DIRECTIVE FORM. This page includes information about New York State advance directive forms and end of life documents. Filled with the kinds of rich patient stories that make the most compelling medical narratives, Extreme Measures thoughtfully and compassionately examines an experience that defines being human. Found inside – Page 551McKinney's Public A health care proxy or similar instruHealth Law $ 2980 ( 5 ) ... form of the health care proxy , requiring 20 404 , 688 N.Y.S.2d 389 ( Sup ... A New York health care proxy can also be called a: New York State Health Care Power of Attorney; Health Care Proxy Form NY; Laws: Article 29-C of the Consolidated Laws of New York's Public Health Law (PHB §2980-2994) governs health care proxies in the state of New York. 0000030959 00000 n Log in to print or send this list to your patient and save lists of resources you use frequently. All hospitals, doctors, and other health care facilities are legally bound to honor the decisions stated in the health care proxy. "Health care provider" would include a PA. PA can write the order. FHCDA surrogate: Yes: Updates to the FHCDA in 2019 specified that the "attending practitioner" must implement the FHCDA Surrogate's decision. A New York medical power of attorney form, or 'Health Care Proxy,' is created for the purposes of appointing an attorney-in-fact to make important medical decisions should there come a time when the principal is unable to make said decisions for themselves. The form also has optional sections that you may or may not choose to complete. ��"��\�X�3). Proxy Form Pdf. 0000006521 00000 n Found insideThis public domain book is an open and compatible implementation of the Uniform System of Citation. We suggest discussing its contents with the person you choose to make your decisions (if you become unable to do so) and your doctor. 0000018483 00000 n montefiore health care proxy form. On this page you will find PDF files of New York Health Care Proxy Forms. Found inside – Page 5Appendix I : Durable General Power of Attorney : New York Statutory Short Form ... 31 • Appendix II : Nondurable General Power of Attorney : New York ... 0000011106 00000 n 0000023962 00000 n 0000003342 00000 n It is easy to complete the simple two-page health care proxy form. Start a free trial now to save yourself time and money! While the hospital encourages patients to prepare these documents there will be no discrimination based on whether or not a patient has . Healthcare Proxy 1430- v. 11/15 (rev HEI) - Spanish . Living Will . Health History Questionnaire. %PDF-1.6 %���� %PDF-1.6 %���� To make things a little confusing, states use various terms to describe their advance directive forms. Access the Health Care Proxy form. 0000024174 00000 n 0000003804 00000 n (2) Optional instructions: I direct my agent to make health care decisions in accord with my wishes and limitations as stated below, or as he or she otherwise knows. Before signing this form, you should understand the following facts: 1. You can give the agent/proxy specific instructions about the . Health Care Proxy Form Instructions - New York. Under New York's Health Care Proxy Law, any competent person can authorize another person (often a family member) to make health care decisions, if the patient becomes unable to do so. 0000004287 00000 n 5. 0000004115 00000 n Health Care Proxy (Poder legal para . A New York Health Care Proxy will be honored in most other U.S. states. Halachic Health Care Proxy Proxy and Directive With Respect To Health Care and Post-Mortem Decisions Introduction This Halachic Health Care Proxy, revised in August of 2009, is designed to help ensure that all medical and post-death decisions made by others on your behalf will be made in accordance with Jewish law and custom (Halacha). These forms are free and provided as a service to all New Yorkers. Upcoming Events. 0000014080 00000 n PAGE 1 of 7. If you would like more information on health care proxies or to obtain a copy of a health care proxy, feel free to contact NAMI-NYS at 800-950-3228. (3) Name of substitute or fill-in agent if the person I appoint above is 0000007350 00000 n NY-RAH is supported by Funding Opportunity Number 1E1CMS331492-01-01 from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services. The New York Health Care Proxy Law allows you to appoint someone you trust to make health care decisions for you if you are unable to communicate or lose the ability to make decisions yourself. Found inside – Page 1Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. In the event that you're unable to express your wishes when it comes to your healthcare decisions, you would need a healthcare proxy document that names someone else as your agent, or proxy. Found inside – Page 4To obtain a copy of the proxy form , updated recently , write : The NYS ... The study surveyed hospital intensive care medical and nursing directors to ... 0000002730 00000 n Health Care Proxy Form New York State law requires us to give you information about your right to choose a person to make healthcare decisions for you if you are unable to make them. La Ley de Poder de Atención Médica de Nueva York (New York Health Care Proxy Law) le permite que designe a alguien de su Found inside – Page 533Cite as 827 N.Y.S.2d 530 ( Sup . ... a power of attorthat had been stolen prior to the guard- ney and health care proxy , is a person who ian's appointment ... Access the Health Care Proxy form. The New York minor power of attorney form is a document that parents can use to authorize a third party to temporarily have parental rights over their child.This type of arrangement is usually used during a period of a parent's absence due to work, military deployment, illness, or education. The core argument of this book is that no one has a moral right to impose rationing decisions on others if they are unwilling to impose those same rationing decisions on themselves in the same medical circumstances. Found inside – Page 277CPR / DNR is a frequent item in living will forms , as well as an example in the NYS Department of Health health care proxy form , mentioned above . Found inside – Page 4922d , Hospitals & Related Health Care Facilities § 32 , Health Care Agents and Proxies . Forms New York Forms Legal and Business § 24 : 143 , Health Care ... By Shae Irving, J.D. This person will be your advocate. 0000030889 00000 n A proxy is a person who has been given authority to act as an agent for another person. Found insideWhat does the Bible really say about money? Before signing, you should understand the following facts: 1. Find your exact New York Revocation of Health Care Proxy form online in the best fillable PDF forms library SellMyForms now! The New York State Health Care Proxy Law allows an adult to designate another adult, such as a trusted friend or loved one who knows the person and his/her wishes, to make treatment decisions if the adult becomes incapacitated and is unable to do so. Healthcare Proxy. You appoint a person and grant to him or her the authority to make medical decisions for you in the event you are unable to express your preferences about . 0000037761 00000 n Found inside – Page 934New York (State). Related Laws value to which the principal is , or may become , or unrestricted short form power of attorney , with powers under under may ... English (PDF)Chinese (PDF)Haitian Creole (PDF)Italian (PDF)Korean (PDF)Russian (PDF)Spanish (PDF) Visit the New York State Department of Health Web site for information on patient rights and advance care planning resources. Found insideConsider this your parenting lifeline: an easy-to-use manual that offers support and perspective. Grown and Flown is required reading for anyone looking to raise an adult with whom you have an enduring, profound connection. For example, you may be too sleepy, too sick, confused, or unconscious. Be sure to include current phone numbers for your health care agent and alternate so they can be contacted in an emergency. (a) Statement of purpose. This Health Care Proxy shall take effect in the event I become unable to make my own health care decisions. 400.21 Advance directives. 0000036753 00000 n Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form. 0000008297 00000 n Patients' Bill of Rights. Health Care Proxy. Part II. 0000002049 00000 n xref Edit, fill, sign, download New York State Health Care Proxy Form online on Handypdf.com. A "health care proxy," sometimes called a "health care surrogate" or "durable medical power of attorney," is a durable power of attorney specifically designed to cover medical treatment. Found inside – Page 165... such as a power of attorney , reflects the concern that unlike guardians ... For example , a New York appeals court overturned the appointment of a ... Found inside – Page 1112Anonymous, 302 A.D.2d 378, 754 N.Y.S.2d 559 (2d Dep't 2003)). ... Pursuant to New York State's Health Care Proxy Law, hospitals, doctors, and other health ... h�bbd``b`f�@��Hp� ��@���X�����x�b``�M�gh�` P� endstream endobj startxref 0 %%EOF 341 0 obj <>stream ⭐ ⭐ ⭐ ⭐ ⭐ Nys health care proxy form 2013 ‼ from buy.fineproxy.org! Found inside – Page 667319 ( 1989 ) ; Comment , Article 80 : New York's Surrogate Health Care ... 1193 ( 1994 ) ; Perling , Health Care Advance Directives : Implications for ... I (name of principal) hereby appoint (name, home address and telephone number of agent) as my health care agent to make any and all health care decisions for me, except to the extent I state otherwise. Probate Code - PROB DIVISION 4.7. 0000005140 00000 n The book looks at the need for appropriate pediatric expertise at all stages of the design, review, and conduct of a research project to effectively implement policies to protect children. That's why the document can perhaps bring a relaxed mind to on your own and your enjoyed ones. 0000019013 00000 n (d) A health care proxy may, but need not, be in the following form: Health Care Proxy. Start a free trial now to save yourself time and money! In this volume, many features of cancer atlases are presented and there are discussions on the areas where moves towards standardization could greatly increase the utility of the finished product. 0000005000 00000 n New York State residents have the right to appoint a health care agent with a Health Care Proxy document and the right to state one's desires concerning life-sustaining treatment with advance directives. Who should have a health proxy? If you regularly spend time in more than one state, it's smart to consider whether a living will, advance directive, or health care power of attorney made in your home state will be valid in the second state, too. 0000031555 00000 n Since 2004 when the 3rd edition of this book was published, there have been a number of legislative changes in the area of health law. This edition keeps you current with these changes, with updates made to all chapters. Health Care Proxy vs. Introduction to Your New York Health Care Proxy and Living Will This packet contains a legal document, a New York Health Care Proxy and Living Will, that protects your right to refuse medical treatment you do not want, or to request treatment you do want, in the event you lose the ability to make decisions yourself. Understand that: 1 you should understand the following form: Health Proxy. 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