Advance Vaccine Card PDF Details

The Advance Vaccine Card form serves as a crucial link between individuals and their healthcare desires, essentially ensuring that their wishes are effectively communicated to healthcare providers in times of need. This wallet-sized notification card carries significant weight, as it contains vital information regarding a person's advanced directives. These include confirmation of discussions about advance directives with family, important contacts, and the current status of a living will or a power of attorney for health care. The card also highlights the distribution of copies of healthcare advance directives to specified contacts, providing their names and contact numbers for both work and evening. This setup not only streamlines the process for healthcare workers trying to respect and follow a patient’s wishes but also acts as a vital piece of preparedness, ensuring that the person's voice is heard even when they might not be able to communicate it themselves. It represents a proactive approach to healthcare, emphasizing the importance of preparedness and clear communication between patients, their families, and healthcare providers.

QuestionAnswer
Form NameAdvance Vaccine Card
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesnotice of legal right advance directives for vaccines, advance vaccine directive card for wallet, advanced vaccine directive, advance vaccine directive

Form Preview Example

WALLET-SIZED ADVANCE DIRECTIVES NOTIfiCATION CARD

This card lets healthcare workers know you have talked to your family about Advance Directives and provides them with contact names and numbers.

NOTICE TO HEALTH CARE PROVDER

Name

I have a living will.

I have a power of attorney for health:

Name

Phone (work)

(evening)

NOTICE TO HEALTH CARE PROVDER

Name

I have a living will.

I have a power of attorney for health:

Name

Phone (work)

(evening)

Copies of Health Care Advance Directives have been given to:

Phone

Phone

Phone

Copies of Health Care Advance Directives have been given to:

Phone

Phone

Phone

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