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Get WV Medical Power Of Attorney

Ss) appoint as my representative to act on my behalf to give, withhold or withdraw informed consent to health care decisions in the event that I am not able to do so myself. The person I choose as my representative is: (Insert the name, address, area code and telephone number of the person you wish to designate as your representative) The person I choose as my successor representative is: If my representative is unable, unwilling or disqualified to serve, then I appoint (Insert the name, addr.

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