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This Form is used for creating a Restricted Power of Attorney in Maryland. It allows an individual to appoint someone else to make decisions on their behalf, but with specific limitations on their authority.
This document allows individuals in Idaho to request a change in their primary physician.
This Form is used for submitting a prior authorization request for Cimzia medication in the state of Vermont.
This Form is used for making medical treatment decisions in Illinois. It is available in both English and Spanish versions.
This document is for parents in Vermont who want to refuse consent for newborn screening for their baby. It is available in Nepali language.
This document is used for Clinician Orders for DNR/CPR and other life-sustaining treatments in Vermont.
This document grants someone the power to act on your behalf in legal matters in the state of Nevada.
This document is used for consenting to do-not-resuscitate (DNR) instructions in the state of Oklahoma.
This Form is used for ordering life-sustaining treatment in Illinois. It is available in both English and Hindi languages.
This form is used for practitioners in Illinois to record a patient's decisions regarding life-sustaining treatment. It is available in both English and Chinese Simplified languages.
This document is for parents in Vermont who do not wish to give consent for their newborn to undergo screening for certain medical conditions.