PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
Form MAID-5
for the current year.
Form MAID-5 Consulting Physician Compliance Form - New Jersey
What Is Form MAID-5?
This is a legal form that was released by the New Jersey Department of Health - a government authority operating within New Jersey. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the MAID-5 Consulting Physician Compliance Form?A: The MAID-5 Consulting Physician Compliance Form is a document used in New Jersey to ensure that physicians are complying with the requirements of the Medical Aid in Dying for the Terminally Ill Act.
Q: Who needs to complete the MAID-5 Consulting Physician Compliance Form?A: Physicians who prescribe medication to aid in dying for terminally ill patients in New Jersey are required to complete the MAID-5 Consulting Physician Compliance Form.
Q: What information is needed on the MAID-5 Consulting Physician Compliance Form?A: The form requires the physician to provide information about the patient, including their diagnosis, prognosis, and mental capacity to make an informed decision.
Q: Is the MAID-5 Consulting Physician Compliance Form required for every case of medical aid in dying?A: Yes, the MAID-5 Consulting Physician Compliance Form must be completed for each case of medical aid in dying in New Jersey to ensure compliance with the law.
Form Details:
- Released on August 1, 2019;
- The latest edition provided by the New Jersey Department of Health;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form MAID-5 by clicking the link below or browse more documents and templates provided by the New Jersey Department of Health.
Download Form MAID-5 Consulting Physician Compliance Form - New Jersey
1
2
