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A Service of United Hospice of Rockland

Forms

This section has all the forms you need to complete your advance directives. Please make sure to print a copy of the authorization form. It must be signed and mailed to us in order for your directives to be stored with Assuringyourwishes.org

 

  • Authorization Form
  • A Health Care Proxy (also known as a health care power of attorney) allows you to appoint a person you trust as your health care agent, who is authorized to make medical decisions on your behalf.
  • A Living Will allows you to document your wishes concerning medical treatments at the end of life.
  • An Organ Donor Designation allows you to document your wishes regarding donating your organs after your death. Even if you have indicated that you would like to be an organ donor, your family or health care proxy/agent must give their permission in order for the donation to take place.

Contact United Hospice of Rockland at (845) 634-4974 or info@hospiceofrockland.org if you would like further information or help.

 

 

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