A healthcare proxy is someone you trust to make healthcare decisions on your behalf if you are not able to communicate your wishes.
Note: If you choose NOT to have a healthcare proxy, you can select no and leave this section blank.
*If you are married and do not appoint anyone as a healthcare proxy, then your spouse has rights to decide medical treatment for you.
**If you are NOT married, and do not appoint anyone as a healthcare proxy, your next of kin may have right to decide medical treatment for you.
If "YES" Please complete the following for healthcare procy. A second healthcare proxy may be listed as a backup in case the first one cannot do it.