Get Or Death With Dignity Act Attending Physician Follow-up Form 2019-2025

Filling out the Oregon Death With Dignity Act Attending Physician Follow-up Form is an essential process for physicians involved in the act. This guide will help you navigate the online form step-by-step, ensuring that you complete it accurately and in a timely manner.

Follow the steps to fill out the form online.

1. Click 'Get Form' button to obtain the form and open it in the editor.
2. Begin by entering the patient's name in the designated field at the top of the form. Ensure that the name is spelled correctly as it appears on official documents.
3. In the 'Did the patient die from ingesting the lethal dose of medication, from their underlying illness, or from another cause' section, select the appropriate option and ensure you provide your signature as the attending physician.
4. If the patient died from ingesting lethal medication, proceed to PART A. Otherwise, if the death was due to underlying illness, stop here and submit page 1 only.
5. In PART A, if you were present at the time of death, you need to complete and sign this section. If not, the section can be filled out by another licensed health provider present at the time of death.
6. Answer the questions in PART A regarding circumstances of ingestion and death, such as dates and locations, as well as complications that may have occurred.
7. Complete PART B, where you will provide details about your care for the patient, including the start date of care and the date when the death with dignity act prescription was written.
8. Make sure to address the series of concerns that may have contributed to the patient's request for lethal medication. Indicate whether each concern was relevant by marking 'yes', 'no', or 'unknown'.
9. Review the entire form for accuracy before signing as the attending physician. Ensure all necessary fields are completed and signatures are provided where required.
10. Once all sections are completed, save any changes made to the form. You can then download, print, or share the form as needed before submitting it.

Complete the OR Death With Dignity Act Attending Physician Follow-up Form online today.