Get Statement Of Choices Form B

Completing the Statement Of Choices Form B online allows users to thoughtfully express health care preferences for someone who cannot voice their decisions. This guide provides step-by-step instructions to ensure clarity and ease in navigating the process.

Follow the steps to successfully complete the form online.

1. Press the ‘Get Form’ button to download and open the Statement Of Choices Form B in your preferred digital format.
2. Fill in the personal details of the individual for whom the form applies, including their name, address, date of birth, and sex.
3. Indicate the current medical conditions of the person and confirm if these health impacts have been explained to you by selecting 'Yes' or 'No'.
4. In Section A, for life-prolonging treatments, select the appropriate options for Cardiopulmonary Resuscitation (CPR) and other life prolonging treatments based on what the person would have chosen.
5. In Section B, identify the medical treatments that the person would like to continue or would not want, making sure to tick the appropriate boxes.
6. In Section C, specify personal values that the individual holds dear, unacceptable future health situations, and preferences regarding the end of life.
7. Provide your details as the Substitute Decision Maker, including your name, phone number, address, and your relationship to the person.
8. Sign the declaration confirming you understand your role and responsibilities as a substitute decision maker.
9. Review the completed form for accuracy; save any changes you made and prepare the document for submission.
10. Send a copy of all three pages of Form B via fax, email, or by post to the relevant health office, making sure to keep a copy for your records.

Start completing your Statement Of Choices Form B online today to ensure your health care preferences are known.