Checklist 5: Adult Patients Without Medical Decision-Making Capacity Who Do Not Have a Health Care Proxy, and Molst Form Is Being Completed in the Community - New York

Checklist 5: Adult Patients Without Medical Decision-Making Capacity Who Do Not Have a Health Care Proxy, and Molst Form Is Being Completed in the Community - New York

Checklist 5: Adult Patients Without Medical Decision-Making Capacity Who Do Not Have a Health Care Proxy, and Molst Form Is Being Completed in the Community is a legal document that was released by the New York State Department of Health - a government authority operating within New York.

FAQ

Q: What is Checklist 5?
A: Checklist 5 is a tool used for adult patients without medical decision-making capacity who do not have a health care proxy in New York.

Q: Who should use Checklist 5?
A: Checklist 5 should be used by medical professionals and caregivers who are completing the Molst form in the community for adult patients without medical decision-making capacity and no health care proxy.

Q: What is the purpose of Checklist 5?
A: The purpose of Checklist 5 is to help guide medical professionals and caregivers in making decisions for adult patients without medical decision-making capacity.

Q: What does the Checklist 5 cover?
A: Checklist 5 covers important considerations such as resuscitation preferences, medical interventions, and end-of-life care for adult patients without medical decision-making capacity.

Q: Is Checklist 5 specific to New York?
A: Yes, Checklist 5 is specific to New York and is used in conjunction with the Molst form.

Q: Can Checklist 5 be used if the patient has a health care proxy?
A: No, Checklist 5 is specifically for adult patients without a health care proxy. If a patient has a health care proxy, a different form or process may be required.

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Form Details:

  • Released on December 1, 2018;
  • The latest edition currently provided by the New York State Department of Health;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the New York State Department of Health.

Download Checklist 5: Adult Patients Without Medical Decision-Making Capacity Who Do Not Have a Health Care Proxy, and Molst Form Is Being Completed in the Community - New York

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  • Checklist 5: Adult Patients Without Medical Decision-Making Capacity Who Do Not Have a Health Care Proxy, and Molst Form Is Being Completed in the Community - New York, Page 2
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