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Advance Decision to Refuse Treatment Fill out the template

Advance Decision to Refuse Treatment

Last revision
Last revision 22/08/2017
Formats
Formats Word and PDF
Size
Size 1 to 2 pages
Fill out the template

About the template

Last revision:22/08/2017

Size:1 to 2 pages

Available formats:Word and PDF

Fill out the template

Advance Decision to Refuse Treatment

This document can be used to inform doctors treating you that you wish to refuse certain life-prolonging treatments. The document and your wish to refuse treatment, will then be applied by doctors treating you if you are otherwise unable to communicate your wishes to them at any time.

This document can be modified to specify the circumstances when you wish to refuse certain treatments, and the nature of the treatments you wish to refuse.

 

How to use this document

It is recommended that you discuss the contents of this document with your GP. You should then sign the document and have it witnessed by at least one other person.

Once the document is signed you should provide a copy to your GP and, if you wish, to any other persons who may hold on to the document so that it can be produced if you fall ill.

You may then wish to periodically review the document, signing and dating it each time to confirm that you still wish to refuse the treatments specified.

 

Any Applicable Law

The Mental Capacity Act 2005 applies to advance decisions.

 

How to modify the template

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At the end, you receive it in Word and PDF formats. You can modify it and reuse it.

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