This is a list of the information that will be entered in the form, which you can gather before you begin.
- Your Personal Information
- Your Name
- Your date of birth
- Your current residence address
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Agents
- You must select an Agent (or attorney in fact) and should select an alternate Agent to carry out your wishes under your Power of Attorney for Health Care
- Name and residence address of the primary and alternate Agents.
- Authority
- You must choose the type of authority to be granted to the agents.
Press Next Page or press buttons on left side of window to continue Power of Attorney for Health Care.
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