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Fill and Sign the Florida Advance Health Care Directive Form 1 PDF Formate

Fill and Sign the Florida Advance Health Care Directive Form 1 PDF Formate

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Open the document and fill out all its fields.
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UNIFORM DONOR CARD of _______________________print or type name of donor The undersigned hereby makes this anatomical gift, if medically acceptable, to take effect on death. The words and marks below indicate my desires:I give: (a) _____ any needed organs, tissues or eyes (b) _____ only the following organs, tissues or eyes _______________________specify the organ(s) or part(s) for the purposes of transplantation, therapy, medical research, or education; (c) _____ my body for anatomical study if needed. Limitations or special wishes, if any: _______________________ (If applicable, list specific donee; this must be arranged in advance with the donee.) Signed by the donor and the following witnesses in the presence of each other: _________________________________ _______________________Signature of donor Date of birth of donor _______________________Date signed_______________________City and State ________________________________ Witness_______________________Witness’Address ________________________________ Witness_______________________ Witness’Address

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