Form MAID-3 Attending Physician Follow up Form - New Jersey

Notification Icon This version of the form is not currently in use and is provided for reference only. Download this version of Form MAID-3 for the current year.

Form MAID-3 Attending Physician Follow up Form - New Jersey

What Is Form MAID-3?

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-3 Attending Physician Follow up Form?
A: The MAID-3 Attending Physician Follow up Form is a form used in New Jersey for monitoring the progress and well-being of patients who have undergone medical aid in dying.

Q: Who uses the MAID-3 Attending Physician Follow up Form?
A: The MAID-3 Attending Physician Follow up Form is used by attending physicians in New Jersey who have prescribed medical aid in dying to a patient.

Q: What is the purpose of the MAID-3 Attending Physician Follow up Form?
A: The purpose of the MAID-3 Attending Physician Follow up Form is to ensure that patients who have obtained medical aid in dying are receiving appropriate follow-up care and support.

Q: What information is included in the MAID-3 Attending Physician Follow up Form?
A: The MAID-3 Attending Physician Follow up Form includes information about the patient's current medical condition, symptom control, and any adverse effects or complications related to the medical aid in dying.

Q: How often is the MAID-3 Attending Physician Follow up Form filled out?
A: The MAID-3 Attending Physician Follow up Form is typically filled out at least once every 15 days following the prescription of medical aid in dying, until the patient's death.

ADVERTISEMENT

Form Details:

  • Released on August 1, 2020;
  • 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;

Download a fillable version of Form MAID-3 by clicking the link below or browse more documents and templates provided by the New Jersey Department of Health.

Download Form MAID-3 Attending Physician Follow up Form - New Jersey

4.8 of 5 (15 votes)
  • Form MAID-3 Attending Physician Follow up Form - New Jersey

    1

  • Form MAID-3 Attending Physician Follow up Form - New Jersey, Page 2

    2

  • Form MAID-3 Attending Physician Follow up Form - New Jersey, Page 1
  • Form MAID-3 Attending Physician Follow up Form - New Jersey, Page 2
Prev 1 2 Next
ADVERTISEMENT