Summary and Questionnaire
Step 1 of 3
The following is a brief summary of the Georgia Advance Health Care Directive. Included are the pertinent questions you need to ask yourself to determine your health care preferences should you not be able to communicate them to your doctors and family members. It is so important to have an Advance Health Care Directive in place before the unthinkable happens like a serious accident or sudden debilitating illness. The State of Georgia on July 1, 2007 to simplify the process and encourage more Georgians to execute an Advance Health Care Directive combined the Living Will (sometimes referred to as a DNR) with the durable power of attorney also called the Health Care Agency appointment. Georgia also included the option to nominate a guardian which would be approved by the court if the court deems guardianship necessary. I would be honored to help you and your spouse execute an Advance Health Care Directive. Please answer the questions below on the next few pages and return to me. I will produce the documents for you to sign and give to your loved ones and health care providers. Spence Hoard Financial Counselor First Baptist Woodstock 678.494.2697
I wish for my preferences in Part Two to be effective if I am in any of the following conditions:
If I am in any condition that I chose above and I can no longer communicate my treatment preferences after efforts have been made to communicate with me, then select A, B or C below.(choose only one).
If you have any questions, please contact us for further information.
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