This is a legal form that was released by the New York State Department of Health - a government authority operating within New York.
The document is provided in Italian. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is the Form 1409 Health Care Proxy Designation Form?
A: Form 1409 is a document used in New York to designate a health care proxy.
Q: What is a health care proxy?
A: A health care proxy is a person who can make medical decisions on your behalf if you are unable to do so.
Q: Who can fill out the Form 1409?
A: Any adult who is mentally capable can fill out the Form 1409.
Q: Is the Form 1409 specific to the Italian language?
A: Yes, the Form 1409 is available in Italian.
Q: Is the Form 1409 specific to New York?
A: Yes, the Form 1409 is specific to New York.
Q: Is there a fee to submit the Form 1409?
A: No, there is no fee to submit the Form 1409.
Q: How long is the Form 1409 valid?
A: The Form 1409 is valid until you revoke it or create a new one.
Form Details:
Download a printable version of Form 1409 by clicking the link below or browse more documents and templates provided by the New York State Department of Health.