THEY WILL BE TRANSFERRED TO THE HOSPITAL OF THEIR CHOICE / Other Facility / _____Residence _____Hospital _____Health Facility If Hospital / Cottage How / /
Movie
Power of Attorney / /
Organization
_____Residence _____Hospital _____Health Facility If Hospital / Burial Trust / Applicant/Responsible Party / Medicare / / /
Position
Attorney / Progress Physician / Admissions Coordinator / trustee / Community Physician / attending physician and Administrator / Attorney for Health Care / /