- Person must be of “Sound Mind” and free of coercion.
- Two disinterested witnesses must attest to such “DecisionMaking Capacity” and to freedom from coercion
- Must have two disinterested witness, who can attest to sound mind and free of coercion when signing form.
- Person’s signature or mark & date the person signed the PAD form 2 disinterested witnesses’ signatures or marks and the date that the disinterested witnesses signed the PAD form
- Agent’s signature or mark and the date the agent signed the PAD form (if applicable)
- Name, Address, and Telephone number of adult’s Health Care Provider (if applicable)
- Name of the Health Care Facility in which the adult is enrolled (if applicable)
Category: Creating Your Own PAD Form