Healthcare Agent
You must write down these two things nine times on page 8 of the MyCare document to determine the authority of your healthcare agent
What are initials
CPR is started when this occurs in the body
What is the heart stopping
This must be presented to the notary before legalizing the document to confirm your identity
What is a government-issued ID
These are the pages required in order for a document to submitted to Cottage
What are pages 6-14
You can have up to this many healthcare agents
What is three
The life-sustaining treatments section of the MyCare document covers mainly these three procedures among others
What are a ventilator, feeding tube, and dialysis
If an individual selects the witness option to legalize their document, one of their witnesses cannot be related by blood, be a spouse, or this
What is receiving money or property after the person’s death
If you do not select a healthcare agent, your healthcare decisions will be carried about a group of these
A board of healthcare professionals
What someone writes on their document if they do not want to select any healthcare agent
What is “I have purposefully not selected a healthcare agent. Please honor my healthcare wishes”
This agency is used by Cottage Health to assist in organ donation
What is OneLegacy
Individuals should not sign this page before meeting with the notary
What is page 12
When submitting documents electronically, PDF copies should be sent to this email
What is MyCare@sbch.org
When revising a choice on the healthcare agent section, individuals must do this to make sure their new choice is correctly communicated to hospital staff
What is crossing out their previous choice and initialing next to it
Corneas, bones, skin, and valves can be donated as these
What are tissues
When submitting an ACP document to Cottage, the person submitting should include these two things
What are the person’s name and DOB
The MyCare document is legal in this many states
What is 42
Your healthcare agent’s authority normally begins when you are unable to speak for yourself during a medical crisis, unless you do this
What is sign at the bottom of Page 8 under "When my health care agent’s authority to make decisions for me becomes effective"
CPR can save a life while this merely prolongs life indefinitely
What is LST
If a person is in a skilled nursing facility, their document must be witnessed and signed by one of these
What is a long term care ombudsman
The POLST form, which requires a medical order, stands for this
What is Physician Orders for Life-Sustaining Treatments