INFORMATION ABOUT THIS DOCUMENT
This is an important legal document, which is governed by D.C. Code §§ 21-2205 to 21-2209, as amended. Before signing this document, it is vital for you to know and understand these facts:
- This document gives the person you name as your attorney-in-fact the power to make health-care decisions for you if you cannot make the decisions for yourself.
- After you have signed this document, you have the right to make health-care decisions for yourself if you have not been certified to be incapacitated to do so. In addition, after you have signed this document, no treatment may be given to you or stopped over your objection if you have not been certified to be incapacitated to make that decision.
- You may state in this document any type of treatment that you do not desire and any that you want to make sure you receive.
- You have the right to take away the authority of your attorney-in-fact, unless you have been adjudicated incapacitated, by notifying your attorney-in-fact or health-care provider either orally or in writing. Should you revoke the authority of your attorney-in-fact, it is advisable to revoke in writing and to place copies of this revocation wherever this document is located.
- You should keep a copy of this document after you have signed it. Give a copy to the person(s) you name as your attorney(s)-in-fact. If you are in a health-care facility, a copy of this document should be included in your medical record.