This version of the form is not currently in use and is provided for reference only. Download this version of Form MAID-5 for the current year.
This is a legal form that was released by the New Jersey Department of Health - a government authority operating within New Jersey. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is the MAID-5 Consulting Physician Compliance Form?
A: The MAID-5 Consulting Physician Compliance Form is a document used in New Jersey to ensure that physicians are complying with the requirements of the Medical Aid in Dying for the Terminally Ill Act.
Q: Who needs to complete the MAID-5 Consulting Physician Compliance Form?
A: Physicians who prescribe medication to aid in dying for terminally ill patients in New Jersey are required to complete the MAID-5 Consulting Physician Compliance Form.
Q: What information is needed on the MAID-5 Consulting Physician Compliance Form?
A: The form requires the physician to provide information about the patient, including their diagnosis, prognosis, and mental capacity to make an informed decision.
Q: Is the MAID-5 Consulting Physician Compliance Form required for every case of medical aid in dying?
A: Yes, the MAID-5 Consulting Physician Compliance Form must be completed for each case of medical aid in dying in New Jersey to ensure compliance with the law.
Form Details:
Download a fillable version of Form MAID-5 by clicking the link below or browse more documents and templates provided by the New Jersey Department of Health.