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(7) <br />ti' d 9 L Z L LVL9017 <br />(6) To consent to and arrange for the administration of pain-relieving drugs of <br />any kind, or other surgical or medical procedures calculated to relieve my <br />pain even though their use may lead to permanent physical damage, <br />addiction oraeven hasten the moment of (but not intentionally cause) my <br />death; to authorize, consent to and arrange for unconventional pain relief <br />therapies which my Agent believes may be helpful to me. <br />To grant, in conjunction with any instructions given under this Article, <br />releases to hospital stn physicians, nurses and other medical and hospital <br />administrative personnel who act in reliance on instructions given by my <br />Agent or who render written opinions to my Agent in connection with any <br />matter described in this Article from all liability for damages suffered or to <br />be suffered by me; to sign documents titled or purporting to be a "Refusal <br />to Permit Treatment" and "Leaving Hospital Against Medical Advice" as <br />well as any necessary waivers of or releases from liability required by any <br />hospital or physician to implement my wishes regarding medical treatment <br />or non- treatment <br />(8) I intend for my agent to be treated as I would be with respect to my rights <br />regarding the use and disclosure of my individually identifiable health <br />information or other me'tical records. This release authority applies to any <br />information governed by the Health. Insurance Portability and <br />Accountability Act of 1996 (a.k.a. HIPAA), 42 U.S.C. 1320(d) and 45 <br />C.F.R. 160 -164. I authorize any physician, health care provider, insurance <br />company, hospital, including all medical attendants, social security <br />administration and the Medical Information Bureau, Inc. or any other <br />healthcare clearinghouse that has provided treatment or services to me, or <br />that has paid for ar is seeking payment from me for such services, to give, <br />disclose and release to my agent, without restriction, all of my individually <br />identifiable health information and medical records regarding any past:, <br />present or future medical or mental health condition, including all hospital <br />records, x-ray film, medical records, reports, statements, insurance data, <br />public certificates and all - other information on file. The information <br />authorized for release may include records whichmay indicate the diagnosis <br />and treatment of a communicable or venereal disease which may include, <br />but is not limited to diseases such as hepatitis, syphilis, gonorrhea and the <br />human immunodeficiency virus (HIV), also know as acquired immune <br />deficiency syndrome (AIDS), mental illness, and drug or alcohol abuse. A <br />copy of this authorization shall have the same authority as the original. The <br />authority given my agent shall supersede any prior agreement that I may <br />have made with my health care providers to restrict access to or prevent <br />disclosure ofmyindividua lip identifiable health informatdon. This authority <br />given my agent has no expiration date and shall expire only in the event <br />that I revoke this authority in writing and deliver it to my health care <br />provider. <br />Page 4 of the Durable Power of Attorney of Elmo E. Nossaman <br />I!O Uegpe2i 9 LZ L. <br />d61.:170 L 1. 90 oea <br />