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Click ‘Get Form’ to open it in the editor.
Select whether you are registering a new directive, amending an existing one, or revoking a previous registration by checking the appropriate box at the top of the form.
If registering a new directive, complete all sections of the form and attach a $10.00 fee. For amendments or revocations, fill out Items 3 and 7 only.
Provide your personal information including name, address, date of birth, and at least one identifying number such as your Social Security Number or Driver’s License Number.
If applicable, enter details for your primary agent and alternate agent who will make health care decisions on your behalf.
Indicate where your advance health care directive will be stored if necessary.
Finally, sign and date the form before submitting it to ensure it is processed correctly.
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Anti-Hazing Commitment Form: As of Fall 2024, this form will now be sent via DocHub to Chapter Presidents, New Member Educators, and Chapter Advisors.Read more
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