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Personal Crisis Plan (Advance Directive) (To be used if the circumstances described on page 2 of this document occur.) Name ___________________________________ Part 1
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Document Date: 2014-07-24 18:58:46

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File Size: 81,68 KB

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MedicalCondition

Allergies / /

MedicalTreatment

Complementary Therapy / /

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Position

Psychiatrist / Pharmacist / Health Care Preparations Physician / /

Product

Purpose_________________________________________________________________ Medication / /

ProvinceOrState

Vermont / /

URL

http /

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