My Personal Directions for Quality Living

August 2018 | The National Consumer Voice and SAGE

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This form provides an opporutnity for you to  record personal preferences and information about yourself in case you need long-term care services in your home or in a long-term care community in the future. 

Complete this form in advance of needing care and provide copies to your emergency contact, durable power of attoreny for health care decissions and place a copy on in your health record. 

You can download a fillable form here