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Get Ca Cha Form 3-1 2016

Ealth care decision for me, I designate as my first alternate agent: Name of individual you choose as first alternate agent: Address: Telephone: (home phone) (work phone) (cell/pager) OPTIONAL: If I revoke the authority of my agent and first alternate agent or if neither is willing, able, or reasonably available to make a health care decision for me, I designate as my second alternate agent: Name of individual you.

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