Appointment of a Healthcare Rep

Patients & Visitors

​Appointment of a healthcare representative

You may appoint a healthcare representative to make medical decisions in the event you become incapacitated. You may specify instructions to be followed by your healthcare representative, who must act in good faith and in your best interest, consistent with the terms of the appointment. In order to be best prepared to honor your best interests, the person who is appointed as your healthcare representative should be made aware of your philosophies, ideologies and faith traditions.

To appoint a valid healthcare representative, you must complete and sign the Appointment of a Healthcare Representative form, and it must be witnessed by an adult other than the appointed representative. In the event that you become incapacitated, the healthcare representative is the sole determiner of your medical choices.

The appointment may be revoked at any time by notifying the representative verbally or in writing. The authority granted by you to the representative through an appointment may be revoked by notifying the healthcare provider verbally or in writing.

Appointment of a healthcare representative form.

 

Back to top