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Or (7) a person who, at the time this power of attorney is executed, has a claim against. Web medical power of attorney designation of health care agent advance directives act (see §166.164, health and safety code) i, (insert your name) appoint:. Designation of health care agent. Except to the extent you state otherwise, this document gives the person you name as your agent the authority to make any and all health care decisions for you in.
Agent’s Name Agent’s Address City State Zip.
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