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200501683 <br />authority contained in this document. In consideration of the <br />medical provider's reliance upon the actions of my attorney -in- <br />fact, I hereby contract to defend, indemnify and save harmless <br />any medical provider who does so rely of and from any and all <br />claims, demands, suits and causes of action which arise from that <br />provider's acts or failures to act as a result of that reliance <br />and brought by me or on my behalf or by any person claiming by, <br />through or under me or as a result of my death. This contract is <br />and shall be fully binding upon my heirs, personal <br />representatives and my estate. <br />I authorize and request any physician, health care <br />professional, health care provider and medical care facility to <br />provide to my Agent information requested by my Agent relating to <br />my physical and mental condition and the diagnosis, prognosis, <br />care and treatment thereof. By this authorization my designated <br />Agent shall be considered as my personal representative under <br />privacy regulations related to protected health information and <br />my designated Agent shall be entitled to all health information <br />in the same manner as if I personally were making the request. <br />This authorization and request shall also be considered a consent <br />to the release of such information under current laws, rules and <br />regulations as well as under future laws, rules and regulations <br />and amendments to such laws, rules and regulations including, but <br />not be limited to, the express grant of authority to personal <br />representatives as provided by Regulation Section 164.502(g) of <br />Title 45 of the Code of Federal Regulations and the medical <br />information privacy law and regulations generally referred to as <br />HIPPA. <br />GUARDIANSHIP <br />I believe that this power of attorney confers adequate power <br />and authority for my Agent to manage my finances and to make all <br />necessary decisions concerning my health and my care. No <br />guardianship or conservatorship should be necessary. However, if <br />any guardianship or conservatorship are commenced to have such a <br />personal representative appointed for me, than I name and <br />nominate my Co- Agents to be appointed in that capacity, to serve <br />along and without posting any surety or any bond that might be <br />required. <br />DURATION OF POWERS <br />I do hereby revoke any and all Durable Powers of Attorney <br />heretofore executed by me. <br />3 <br />T <br />