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Proxy Consent Form
"I need a Proxy Consent Form under Hong Kong law for my upcoming medical treatment in March 2025, appointing my sister as primary proxy and my eldest son as alternate proxy, with specific powers regarding experimental treatments and life-support decisions."
1. Parties: Identifies the Principal (person giving consent), the Proxy (person receiving authority), and any alternate proxies
2. Background: Brief context explaining the purpose of the proxy consent arrangement and relationship between parties
3. Definitions: Key terms used throughout the document, including medical, legal, and technical terminology
4. Appointment of Proxy: Formal designation of the proxy and the general scope of their authority
5. Powers Granted: Detailed description of specific decisions and actions the proxy is authorized to make
6. Duration and Effect: Period for which the proxy consent is valid and conditions under which it becomes effective
7. Principal's Declaration: Statement confirming the principal's current mental capacity and voluntary execution
8. Execution Requirements: Signature requirements, witnessing provisions, and any certification needs
1. Alternate Proxy Provisions: Used when naming backup proxies in case the primary proxy is unavailable or unable to act
2. Specific Medical Conditions: Include when the proxy consent relates to specific medical conditions or treatments
3. Religious or Cultural Preferences: Added when specific religious or cultural considerations should guide proxy decisions
4. Revocation Procedures: Include when specific revocation procedures need to be outlined beyond standard legal provisions
5. Emergency Contact Information: Optional section for listing additional emergency contacts beyond the proxy
1. Schedule 1 - Medical Information: Details of relevant medical conditions, medications, or treatment preferences
2. Schedule 2 - Identification Documents: Copies or details of identity documents for all parties
3. Schedule 3 - Witness Attestation Form: Detailed witness information and attestation requirements
4. Appendix A - Healthcare Provider Information: List of relevant healthcare providers and their contact information
5. Appendix B - Certification of Capacity: Medical practitioner's certification of the principal's mental capacity (if required)
Authors
Proxy
Alternate Proxy
Personal Care
Medical Treatment
Healthcare Provider
Mental Capacity
Effective Date
Revocation
Emergency Treatment
Best Interests
Medical Records
Personal Information
Advance Directive
Certification of Capacity
Healthcare Facility
Life-Sustaining Treatment
Material Change
Professional Opinion
Reasonable Care
Termination Date
Witness
Medical Practitioner
Personal Care Decision
Healthcare Decision
Notarial Certification
Incapacity
Treatment Plan
Consent
Governing Law
Jurisdiction
Valid Notice
Registered Medical Institution
Authorized Representative
Legal Representative
Authority
Powers and Duties
Medical Decisions
Personal Care
Duration
Capacity
Execution
Revocation
Privacy and Confidentiality
Emergency Powers
Limitations
Witnessing
Certification
Alternate Appointment
Information Access
Communication
Best Interests
Indemnification
Governing Law
Data Protection
Healthcare Instructions
Religious Preferences
Cultural Considerations
Termination
Notice Requirements
Record Keeping
Dispute Resolution
Healthcare
Legal Services
Insurance
Elder Care
Medical Services
Social Services
Mental Health Services
Disability Services
Aged Care Facilities
Hospital Administration
Legal
Compliance
Medical Administration
Patient Services
Risk Management
Clinical Operations
Document Management
Healthcare Operations
Social Services
Quality Assurance
Healthcare Administrator
Legal Counsel
Medical Director
Compliance Officer
Risk Manager
Patient Relations Manager
Social Worker
Medical Practitioner
Elder Care Coordinator
Legal Administrator
Healthcare Facility Manager
Clinical Services Director
Patient Advocate
Medical Records Manager
Legal Services Coordinator
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