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  • Form 5-7 End-of-life Option Act Attending Physician ...

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FORM 57ENDOFLIFE OPTION ACT ATTENDING PHYSICIAN CHECKLIST & COMPLIANCE FORM PATIENT INFORMATION Patients Name:(last)(first)(M.I.)Date of Birth:Patients Address:(street)(city)(zip code)ATTENDING.

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Patient must make three requests for the aid-in-dying drug to his or her attending physician – two orally (at least 15 days apart) and one in writing on a special form that is witnessed. Attending physician must be willing to prescribe an aid-in-dying drug and must make sure the patient legally qualifies.

The average time for the complete process is three weeks. Our physicians do a comprehensive review before prescribing aid in dying medication for any patient. The waiting period between the first and second oral requests is 48 hours.

The 2015 End of Life Option Act (ELOA) authorizes an adult who meets certain qualifications, and who has been determined by his or her attending physician to be suffering from a terminal disease, to make a request for a drug prescribed pursuant to these provisions for the purpose of ending his or her life.

The End of Life Option Act (EOLOA) allows terminally ill adult Californians to request a prescription for medication to hasten death under some conditions.

The End of Life Option Act allows an adult diagnosed with a terminal disease, who meets certain qualifications, to request the aid-in-dying drugs from their attending physician. The Act requires physicians to submit specified forms and information to the California Department of Public Health (CDPH).

The End of Life Option Act allows an adult diagnosed with a terminal disease, who meets certain qualifications, to request the aid-in-dying drugs from their attending physician. The Act requires physicians to submit specified forms and information to the California Department of Public Health (CDPH).

The End of Life Option Act (PDF) is a California law that went into effect on June 9, 2016, and was updated on January 1, 2022. The law allows individuals who have a serious, life-limiting illness (with a prognosis of six months or less) to request prescription medications from their doctor to end their life.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232