|
What to do with your health care proxy form
- Make copies of this your proxy form for your agent and anyone else who may be involved with your care including your physician, members of your family, and your spiritual advisor.
- Keep the original in a place that is easily found.
- Make sure your proxy form is available when needed by filing your form with the free, secure, on-line service, AssuringYourWishes.org.
- If you complete a Living Will Form and/or a Do Not Resuscitate Order, these forms can also be stored on AssuringYourWishes.org.
What is www. AssuringYourWishes.org?
Once you have Shared Your Wishes, selected your health care agent, and completed a NYS health care proxy form, or other advance directive - assure your wishes by storing your health care proxy form in a safe and private registry called AssuringYourWishes.org. Your forms are available anytime, anywhere yet your privacy is protected.
It has been estimated that 20-30% of adults have an advance directive, yet when these documents are needed they are available in only about 1 in 3 cases. AssuringYourWishes.org provides a safe, confidential place to store your advance directives. The documents filed in the registry are only accessible over the Internet. Care providers are able to easily view your documents to see your wishes using your personal passcode.
The service is provided free of charge through a collaborative effort by the Sharing Your Wishes Coalitions, the Community Health Foundation of Western and Central New York, and the NYS Hospice and Palliative Care Association. The service is administered by AssuringYourWishes.org.
For more information about Assuring Your Wishes go to www.assuringyourwishes.org
back to top
- Print a copy of the health care proxy to designate your health care agent, and if you want to state your specific requests for life sustaining treatments, print out a copy of the living will form.
- Complete the form(s), sign them and make sure they are witnessed.
- Print the AssuringYourWishes.org authorization form and sign it. [See your county information page for a link to the form]
- Mail copies of your documents to your local contact.
- Upon receipt, a representative of your local Sharing Your Wishes coalition will review the documents and return them to you if they are not legible or not witnessed appropriately.
- After your documents are scanned and entered into the website, your original forms will be returned to you. You will also receive three wallet cards with your personal passcode.
- Put a copy of your wallet card in your wallet and share the cards with your health care agent and physician.
You can review your advance directives on the website www.AssuringYourWishes.org.
back to top
What happens after you sign your health care proxy form?
After you have signed your proxy form, you still have the right to make all your health care decisions as long as you are able to do so.
It is not easy to talk about how you want to live the last phase of life. But, avoiding the conversation may actually make it harder for those you love.
The time to talk is now. Have a conversation before you experience a health crisis, when you are able to share what is important to you. This can greatly reduce the worries for those who care about you. They won't have to guess what you want. If you don't share your wishes, how can they be respected?
Give those you love peace of mind—not uncertainty and tough choices.
If you have questions or to request copies of the Sharing Your Wishes materials contact the nearest Sharing Your Wishes Coalition.
|
Advance Directives
