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2011-12-05_REVISION - M1982020
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2011-12-05_REVISION - M1982020
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Entry Properties
Last modified
6/16/2021 2:21:01 PM
Creation date
1/23/2012 7:58:37 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1982020
IBM Index Class Name
REVISION
Doc Date
12/5/2011
Doc Name
SO Application
From
Aspen Mineral Resources, Inc.
To
DRMS
Type & Sequence
SO2
Email Name
GRM
SSS
Media Type
D
Archive
No
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Ed <br />Artie(' for me based upon what my Agent believes to be in my best interests. Accordingly, my Agent <br />is authorized as follows: <br />(1) <br />To request, receive arid review any information, verbal or written, regarding <br />my personal affairs or my physical or mental health, including medical and <br />hospital records, and to execute any releases or other documents that may <br />be required in order ua obtain such information, and to disclose such <br />information to such persons, organizations, firms or corporations as my <br />Agent shall deem appropriate; <br />(2) To employ and discharge medical personnel including physicians, <br />psychiatrists, dentists, nurses, and therapists as my Agent shall deem <br />necessary for my physical, mental and emotional well- being, and to pay <br />them, or any of them, reasonable compensation. <br />(3) To give consent to any medical procedures, tests or treatments, including <br />surgery; to arrange for my hospitalization, convalescent care, hospice or <br />home care; to summon paramedics or other emergency medical personnel <br />and seek emergency treatment for me, as my Agent shall deem appropriate; <br />and under circumstances in which my Agent determines that certain <br />medical procedures, tests or treatments are no longer of any benefit to me <br />or, based on instructions previously given by me are not desired by me <br />regardless ofbenefit, to revoke, withdraw, modify or change consent to such <br />procedures, tests and treatments, as well as hospitalization, convalescent <br />care, hospice or home care which I or my Agent may have previously <br />allowed or consented to or which may have been implied due to emergency <br />conditions. <br />(4) To arrange (upon execution of a certificate by two independent <br />psychiatrists who have examined me and in whose opinions I am in <br />immediate need of hospitalization because of mental disorders, alcoholism <br />or drug abuse) for my voluntary admission to an appropriate hospital or <br />institution for mental health treatment; to arrange for private psychiatric <br />and psychological treatment for me; and to revoke, modify, withdraw or <br />change consent to such mental health treatment, including hospitalization, <br />institutionalization or private treatment which I or my Agent may have <br />l ae!Piously given. The consent of my Agent to my hospitalization for <br />psychiatric help, alcoholism or drug abuse shall have the same legal effect, <br />subject to applicable local law, as a voluntary admission made by me. <br />Mental health treatment is defined as convulsive treatment and/or <br />treatment with psychoactive medication, and/or admission to and retention <br />in health care facrlity far aperiod up to twenty -eight (28) days. Although <br />my Agent is otherwise authorized to make mental health decisions for me, <br />my Agent is not authorized to consent to any convulsive treatment in or for <br />ray behal£ . <br />(5) To exercise my right of privacy to make decisions regarding my medical <br />treatment and my right: to be left alone even though the exercise ofmyright <br />might hasten my death or be against conventional medical advice. <br />Page 3 of the Durable Power of Attorney of Elmo E. Nossaman <br />gl.Z1.1.17L9017 <br />!!O Ue4Pe2i g21. <br />d61 :170 L I. 90 oea <br />
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