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202005711 <br />instructions given by my Agent or who render written opinions to the Agent from all liability for <br />damages. This authorization is intended to provide my health care providers with the authorization <br />necessary to allow each of them to disclose such general psychiatric information and protected <br />health information regarding me to the above designated agents. The information disclosed by any <br />such health care provider pursuant to this authorization is subject to further disclosure and use by <br />such designated agents and may thereafter no longer be protected by such privacy rules. This <br />authorization shall remain in effect until the earlier of its revocation by me or my death. <br />(3) Power to Obtain Medical Records to Determine Incapacity. When it is necessary <br />or appropriate to inquire about the physical or mental health of the Principal and notwithstanding <br />any condition precedent otherwise contained in the document, the Agent is authorized to request, <br />receive, and review any information, verbal or written, regarding the Principal's physical or mental <br />health, including medical and hospital records. The Agent may execute any releases or other <br />documents that may be required to obtain such information and to disclose such information to <br />such persons, organizations, firms, or corporations as my Agent shall deem appropriate. The <br />Agent shall have powers granted by all applicable state and federal law, including the Health <br />Insurance Portability and Accountability Act ("HIPAA"). For such purposes, I do hereby <br />designate my Agent as my "personal representative" with all the authorities granted to such person <br />under HIPAA. The Agent may grant releases to hospital staff, physicians, and other health care <br />providers who act in reliance on instructions given by my Agent or who render written opinions to <br />the Agent from all liability for damages. This authorization is intended to provide my health care <br />providers with the authorization necessary to allow each of them to disclose such general medical <br />information and protected health information regarding me to the above designated agents. The <br />information disclosed by any such health care provider pursuant to this authorization is subject to <br />further disclosure and use by such designated agents and may thereafter no longer be protected by <br />such privacy rules. This authorization shall remain in effect until the earlier of its revocation by <br />me or my death. <br />(4) Power to Employ and Discharge Health Care Personnel. My Agent is authorized <br />to employ, compensate, and discharge health care personnel as my Agent shall deem necessary. <br />(5) Power to Give, Withhold, or Withdraw Consent to Health Care Treatment. My <br />Agent is authorized to give, withhold, withdraw, or modify consent to any health care procedures, <br />tests, or treatments, including surgery; to arrange for my hospitalization or other care; to summon <br />emergency medical personnel and seek emergency treatment for me, as my Agent shall deem <br />appropriate; to give, withhold, withdraw, or modify consents for procedures and care. <br />(6) Power to Give or Withhold Consent to Psychiatric Treatment. My Agent is <br />authorized to arrange, on the execution of a certificate by two independent psychiatrists who have <br />examined me and in whose opinions I am in immediate need of hospitalization because of mental <br />disorder, alcoholism, or drug abuse, for my voluntary admission to an appropriate hospital or <br />institution for treatment of the diagnosed problem; to arrange for my treatment; and to revoke, <br />modify, withdraw or change consent to such treatment. <br />Durable Power of Attorney for Janice S. Nikodym Page 7 <br />