RSA 137-J:19 Advance Directive; Disclosure Statement.
Title: X - PUBLIC HEALTH
Chapter: 137-J - WRITTEN DIRECTIVES FOR MEDICAL DECISION MAKING FOR ADULTS WITHOUT CAPACITY TO MAKE HEALTH CARE DECISIONS
The disclosure statement which must accompany an advance directive shall be in substantially the following form:
AN ADVANCE DIRECTIVE IS A LEGAL DOCUMENT. YOU SHOULD KNOW THESE FACTS BEFORE SIGNING IT.
BULLET This form allows you to choose who you want to make decisions about your health care when you cannot make decisions for yourself. This person is called your "agent". You should consider choosing an alternate in case your agent is unable to act.
BULLET Agents must be 18 years old or older. They should be someone you know and trust. They cannot be anyone who is caring for you in a health care or residential care setting.
BULLET This form is an "advance directive" that defines a way to make medical decisions in the future, when you are not able to make decisions