By signing this appointment of health care representative, I appoint a health care representative with legal authority to make health care decisions on my behalf in such case or at such time.

Pediatric TB Clinic: 1st and 3rd Wednesdays, 1:00pm Mailing address: 20 York Street New Haven, CT 06510 Must be physician or Health Department referred. Need a screening test …

You must request transportation a minimum of 48 business hours before your appointment unless it’s for Public Transit. Public transit requests require at least 7 to 10 business days advanced …

They cut through all lanes. They wait on the side of the road. "Fatigue increases the risk of:" Missing an exit. Being late for an appointment. Falling asleep behind the wheel and crashing. …

APPOINTMENT OF HEALTH CARE REPRESENTATIVE appoint _______________________________________________ to be my health care representative.

A combined advance directive form includes all of the advance directives- appointment of health care representative, living will, appointment of conservator and organ donation into one form.

Time sheets must be submitted by the end of the day on the Thursday at the end of the payperiod. Time sheets may be submitted up to two (2) payperiods ahead of time and …

Entry Requirements for Appointment as a Police Officer Lateral Comparative Certification Full Time New Hire

Application for Renewal of Notary Public Appointment Filing Fee $60.00 Make checks payable to “Secretary of the State” Notary Name Commission Expiration Date

SECTION 1 If you are requesting a Commercial Driver Skills Test Appointment you must provide the following information: Select testing location: Mansfield Location 190 South Frontage …