Attending Physician's Compliance Form.pdf

Attending Physicians Compliance Form.03.14.18.pdf
Preview of Attending Physician's Compliance Form
🔗 Source: dchealth.dc.gov
📊 Size: 80 KB
📄 Pages: 2 pages
⬇️ Downloads: 39

Summary

This form is for attending physicians to document compliance with the Death with Dignity Act of 2016 in Washington D.C. It requires patient information, physician information, and details about the actions taken to comply with the law, including oral requests, written requests, medical consultations, and psychiatric evaluations. The form must be completed and signed by the attending physician, confirming that all requirements under the Act have been met.

Description

This form is for attending physicians to document compliance with the Death with Dignity Act of 2016 in Washington D.C.

Technical Information

  • File Format: PDF
  • File Size: 80 KB
  • Pages: 2
  • Language: EN
  • Total Downloads: 39
  • Last Updated: 1 week ago

Document Overview

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