Page 73 - Guardian Hospice Care
P. 73

             ADVANCE DIRECTIVES STATUS
Name: Date:
Advance Directive Rights and Policies have been explained:
Resident has:
• Living Will
(State of LA Declaration)
• Durable Power of Attorney for Healthcare
• General Power of Attorney
• Nursing Facility DNR
• DNR Order
Yes No
Yes No
Yes No Yes No Yes No Yes No
            • LAPOST   Yes   No
• Other   Yes   No




















































































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