Follow the steps to complete the form correctly

1. Click the ‘Get Form’ button to access the document and open it in the form editor.
2. In Section 1, enter the date you became terminally ill in the designated space.
3. Proceed to Section 2 where you will provide your signature. Ensure that your name is printed clearly in the space provided.
4. Sign the form in the area designated for the owner's or trustee's signature.
5. Complete the date field in Section 2 to indicate when you signed the form.
6. Next, find the area for the physician’s information. Print the physician's name clearly in the designated field.
7. Have the physician sign in the space provided to validate the diagnosis.
8. Finally, the physician should complete the date section, confirming when they signed the form. Once all information is complete, review the form for accuracy.
9. Save your changes, download, print, or share the completed form according to your needs.

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