| Principal Information |
This is the name of the person preparing the Living Will.
then Enter address in the format of Address ; City, State , Zip.
Be sure to include your phone number.
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| Primary Decision Maker |
Primary Decision Maker is the person that you want to make desicisons if you are unable.
Be sure to include their phone number.
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| Alternate Decision Maker No. 1 |
Alternate Decision Maker 1 and 2 may act as alternates if your Primary Decision Maker is unavailable or unwilling to act.
You do not have to list Alternate's, however it is wise to have at least one as a backup.
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| Alternate Decision Maker No. 2 |
Alternate Decision Maker 1 and 2 may act as alternates if your Primary Decision Maker is unavailable or unwilling to act.
You do not have to list Alternate's, however it is wise to have at least one as a backup.
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| Your Contact Information |
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