Statutory and Durable Health Care Power of Attorney - Rhode Island

(2) CREATION OF DURABLE POWER OF ATTORNEY FOR HEALTH
CARE. By this document I intend to create a durable power of
attorney for health care.
(3) GENERAL STATEMENT OF AUTHORITY GRANTED. Subject to
any limitations in this document, I hereby grant to my agent full
power and authority to make health care decisions for me to the same
extent that I could make such decisions for myself if I had the capacity
to do so. In exercising this authority, my agent shall make health care
decisions that are consistent with my desires as stated in this
document or otherwise made known to my agent, including, but not
limited to, my desires concerning obtaining or refusing or
withdrawing life-prolonging care, treatment, services, and procedures
and informing my family or next of kin of my desire, if any, to be an
organ or tissue donor.
(If you want to limit the authority of your agent to make health care
decisions for you, you can state the limitations in paragraph (4)
("Statement of Desires, Special Provisions, and Limitations") below.
You can indicate your desires by including a statement of your desires
in the same paragraph.)
(4) STATEMENT OF DESIRES, SPECIAL PROVISIONS, AND
LIMITATIONS. (Your agent must make health care decisions that are
consistent with your known desires. You can, but are not required to,
state your desires in the space provided below. You should consider
whether you want to include a statement of your desires concerning
life-prolonging care, treatment, services, and procedures. You can also
include a statement of your desires concerning other matters relating
to your health care. You can also make your desires known to your
agent by discussing your desires with your agent or by some other
means. If there are any types of treatment that you do not want to be
used, you should state them in the space below. If you want to limit in
any other way the authority given your agent by this document, you
should state the limits in the space below. If you do not state any
limits, your agent will have broad powers to make health care
decisions for you, except to the extent that there are limits provided
by law.)
In exercising the authority under this durable power of attorney for
health care, my agent shall act consistently with my desires as stated
below and is subject to the special provisions and limitations stated
below:
(a) Statement of desires concerning life-prolonging care, treatment,
services, and procedures:
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Statutory and Durable Health Care Power of Attorney - Rhode Island DOC

Statutory and Durable Health Care Power of Attorney - Rhode Island PDF

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