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<br /> �his is an iap�ortsnt loqal docua�nt. it cr�t�a a pa�r� oF --
<br /> attarnwy !or lwitb cas�. er�tor� •iqning this doaus�nt you _
<br /> shoulc, lcnov thass iapo�ctant �u't�:
<br /> (a) �h�s dtoa�aaunt qivde tM parson you e3�siqnat� as yaur
<br /> attor�y-in-tact tha powr to �s]c� hsaltb carce daafsio� for pau
<br /> vh�� �ou ar� dat.�r�i�wd to b� incspabl�. ]►ithouqh not nec�sa�cy
<br /> anc� t�itt�r �cou�'aq�d nor aisaoursqa�, you aay wish to state
<br /> instructiwss or vio3Nar and lisft ths nuthority o! yaisx' attorn�y-
<br />' in-faat;
<br /> (b) Subj�ct to th� liaaltation �tat�l in suhdivision (d) o!
<br /> thfs docua�at, the p�cson You d�sic�ats as your attornsy-in-fact
<br /> haa a duty to act consi�'t�ntly with your do ir�sa i! your d�airas
<br /> thi• docu�nt or oth�rvis� aads kno�+n bY Y
<br /> ar� u�n]cno�m, to act in a aanusar consistont with ycur bsst
<br /> intsrssts. Ttu parso�n yau c�siqnat� in tAis docua�nt doss,
<br /> hawva�c, haw th� riqht to witharav tro� this duty at any t�w;
<br /> (c� Yau say s�rciiy that any dstanination that you ar�
<br /> incapabl� ot aalcing h�alth caro decisions sust ba contirasa by a
<br /> sac�and physfcia�n;
<br /> � �(d) T� psrson You d�si9nat� as your attorn�y-in-laot will
<br /> ' not hav� th� autharity !o. cons�rt to t1u vithholding or
<br /> vitt�dua�l o! lila-suataining proc�dux�ss or o! artiliciaily
<br /> � sdainiot�r�c3 nutrition or hyr]ration unl�ss yon qiv� bia or 3�ar -.
<br /> tbat suthor�ty• in this po�a� o! attorn�y �or hsalth car� or in
<br /> sc� oth�r cl�ar �ud co�nyincing ssn�a�r:
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<br /> (�) Tbis pov�r o! attortu�y !or hsalth cars ahould b� - __...-- _.- ------.
<br /> r�viaw�d paricd.ically. =L will continu� in �!lect i�d�tinit��.Y
<br /> , � unl�ss you �xarcis� yowc rigtit to r�vok� ft. You hav� tha riqbt
<br /> � to ravok� tbi� pow�r of attorney at any tfaQ whila you ar�
<br /> co�t�t bY notilYing th� attornay-fn-tact, your hralth care
<br /> prov�dsr, or th� lacility ias wbich you ars a patient or rssiduat
<br /> o! tt� rsvocation orally or in writinq;
<br /> , (!) D�spite an� provi�fons isa tDfs po�ar o! attortssy for �
<br /> h�altb aars, you ha�rna thr right tio �ake tuslth car� dscisions !or
<br /> r ��i�a,,*� as you ars nat iacapabls o! nakinq those .
<br /> i! th�r� is aayt3�3ng in this powr ot attorn�y ta�r
<br /> �l��� yo�s do nat �sWa�Cata�d, you should ss�lc logsl advic�.
<br /> This �r a! attarnsy �or haalth car� will not bo vaifd !or
<br />_ sak�ang baalth care d�cfsfons unle�s it ia siqn�d by two qualitiQd
<br /> witrwsa�s 1�rLo ar� p�rsanal�y known to you and who are pr�a�ent
<br /> vLs�► you sign or ack�owl�e your siqnature.
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