Get Montefiore Health Care Proxy Form

Filling out the Montefiore Health Care Proxy Form online is a significant step in ensuring your health care wishes are respected when you may be unable to communicate them. This guide provides clear instructions to help you navigate each section of the form with confidence.

Follow the steps to complete your Health Care Proxy Form online effectively.

1. Press the ‘Get Form’ button to access the Health Care Proxy Form and open it in the editor.
2. In the first section of the form, enter the name, home address, and telephone number of the person you are appointing as your health care agent.
3. If you wish to designate an alternate agent, fill in their name, home address, and telephone number in the subsequent section.
4. If you want your Health Care Proxy to expire after a certain date or condition, specify that information in the appropriate field. If not, this proxy remains valid indefinitely.
5. Provide any special instructions for your agent in the designated area. Clearly outline any limitations to their authority or specific wishes regarding your health care decisions.
6. Make sure to date and sign the form. If you cannot sign, direct someone to sign in your presence while you observe.
7. Indicate your wishes regarding organ and/or tissue donation, if applicable, in the optional section provided.
8. Two individuals, who are 18 years of age or older and not appointed as your agent, must sign as witnesses.
9. After completing the form, save your changes. You can then download, print, or share the form as needed.

Complete your Health Care Proxy Form online today to ensure your health care preferences are documented and respected.