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Directiva Por Anticipado De La Atencion De La Salud

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[Homepage] [Get Documents Now] [Directiva Por Anticipado De La Atencion De La Salud] [Do More Research] [We Want to Hear from You!] [Request a DVD] [Send DVD as a Gift]

We Want to Hear from You!

We would like to provide the best possible service. Your feedback helps us do the best job we can. Please take a minute to let us know what you think.

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Do you provide care for a family member?
Is your family member age 65 or older?
Are you 55 or older caring for a family member 17 or younger?
Is anyone in your family living with dementia?
Are you or someone in your family living with a diagnosis of a terminal illness? If yes, what illness?
On a scale of 1 to 5, how helpful was the video?
Do you intend to complete advance planning forms with your loved one?
Do you intend to complete advance planning forms for yourself?
On a scale of 1 to 5, are you more likely to complete the forms having viewed the video?
Are you female or male?
Have you ever attended a caregiver support group?
What else would you like us to know?