Form MAID-6 Request for Medication to End My Life in a Humane and Dignified Manner - New Jersey

What Is Form MAID-6?

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.

FAQ

Q: What is Form MAID-6?
A: Form MAID-6 is a request for medication to end one's life in a humane and dignified manner in New Jersey.

Q: Who can use Form MAID-6?
A: Form MAID-6 can be used by qualified terminally ill adults in New Jersey.

Q: What is the purpose of Form MAID-6?
A: Form MAID-6 is used to request medication for medical aid in dying, allowing individuals to peacefully and autonomously end their lives.

Q: How can I obtain Form MAID-6?
A: To obtain Form MAID-6, you should consult with your healthcare provider or physician who can provide you with the necessary information and assistance.

Q: What are the requirements to use Form MAID-6?
A: To use Form MAID-6, you must be a qualified terminally ill adult, have the mental capacity to make healthcare decisions, and meet other specific criteria outlined in New Jersey's Medical Aid in Dying for the Terminally Ill Act.

Q: Are there any fees associated with Form MAID-6?
A: There are no fees associated with completing Form MAID-6.

Q: What happens after I submit Form MAID-6?
A: After submitting Form MAID-6, your healthcare provider will review your request and determine if you meet the appropriate criteria. If approved, you will receive a prescription for the medication to end your life.

Q: Is the use of Form MAID-6 legal in New Jersey?
A: Yes, the use of Form MAID-6 is legal in New Jersey under the Medical Aid in Dying for the Terminally Ill Act.

Q: Can someone else complete Form MAID-6 on my behalf?
A: No, Form MAID-6 must be completed and signed by the qualified terminally ill individual themselves.