UNOFFICIAL COPY OF SENATE BILL 369 J1 (6lr2183) ENROLLED BILL Education, Health, and Environmental A 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin with Part I: Selection of Health Care Agent. Fill in the name, address, and telephone numbers of your primary agent who will make health care decisions on your behalf.
  3. If desired, select back-up agents by providing their details. This is optional but recommended for continuity.
  4. In Part II, outline your treatment preferences. You can specify your wishes regarding life-sustaining procedures under different medical conditions.
  5. Complete Part III by signing the document in front of two witnesses. Ensure that at least one witness does not stand to gain from your estate.
  6. Review all filled sections periodically and share copies with your health care agent and doctor to ensure they are informed of your wishes.

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