Hawaii Advance Health Care Directive Page 7
Download a blank fillable Hawaii Advance Health Care Directive in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Hawaii Advance Health Care Directive with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4
5
6
7
8(signature of witness)
(printed name of witness)
(address)
(city)
(state)
Witness
I declare under penalty of false swearing pursuant to section 710-1062, Hawaii Revised
Statutes, that the principal is personally known to me, that the principal signed or
acknowledged this power of attorney in my presence, that the principal appears to be of
sound mind and under no duress, fraud, or undue influence, that I am not the person
appointed as agent by this document, and that I am not a health-care provider, nor an
employee of a health-care provider or facility.
(date)
(signature of witness)
(printed name of witness)
(address)
(city)
(state)
ALTERNATIVE NO. 2
State of Hawaii
County of
On this
day of
, in the year
, before me,
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Medical