[{"id":"b629531c-d24f-4fc1-a9d8-28324f91e14b","order":1,"text":"POWER OF ATTORNEY FOR PERSONAL CARE","fontSize":"22","textAlign":"center","bold":true,"underline":false,"marginBottom":"5","cflou":false,"active":true},{"id":"721fb9f3-1c5a-4cc7-ab17-cb91d21ff94e","order":2,"text":"AND ADVANCE DIRECTIVE (LIVING WILL)","fontSize":"16","textAlign":"center","bold":true,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"48eedda1-d710-4085-9865-5a82909e6f21","order":3,"text":"I, [Full legal name], born on [Date of birth], of [Street address], [City], [Province or territory] (the \"Grantor\", \"I\", \"me\" or \"my\"), being of the age of majority and of sound mind, and intending to provide for my personal care and health care in the event of my future mental incapacity, make this Power of Attorney for Personal Care and Advance Directive (this \"document\").","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"fa810aef-5805-4ec0-b0a0-68a807a28e91","order":4,"text":"I make this document freely and voluntarily, without duress, undue influence or coercion. I understand the nature and effect of this document, namely that it (i) appoints a substitute decision-maker to make personal care and health care decisions on my behalf if I become incapable of making them myself, and (ii) records my wishes, values and instructions to guide and, to the fullest extent permitted by law, to bind my attorney and my health practitioners. I confirm that, at the date of signing, I understand the information relevant to making this document and appreciate the reasonably foreseeable consequences of making it.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"a5ba2d55-2f1a-4751-90f7-e9e69e24e264","order":5,"text":"1. APPOINTMENT OF ATTORNEY FOR PERSONAL CARE","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","sectionNum":"S01"},{"id":"1a18887a-5e50-473b-a34b-aae7435a8353","order":6,"text":"I appoint [Attorney full name], my [Relationship to you], of [Attorney address] (telephone: [Attorney telephone]), to be my attorney for personal care (the \"Attorney\").","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"7d9cb6ed-5684-4589-bb72-39e93604dfa4","order":7,"text":"I authorize my Attorney to make, on my behalf, any decision concerning my personal care that I am mentally incapable of making for myself at the relevant time, including decisions relating to health care, medical treatment, nutrition, hydration, shelter, residence, clothing, hygiene, safety and comfort, subject always to the wishes, instructions, restrictions and limitations expressed in this document.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"01fae732-026a-43b6-a9b5-aa9006a4abb6","order":8,"text":"2. SUBSTITUTE ATTORNEY FOR PERSONAL CARE","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","displayConditions":[{"field":"5d60a6f4-a744-4bca-a4c2-4cf6ac2b2923","value":"1","type":"add","operator":"="}],"sectionNum":"S02"},{"id":"2fe7495f-310b-447d-b55d-fa9016b25d8c","order":9,"text":"If my Attorney named above dies, becomes mentally incapable, resigns, refuses or is unable to act, or is otherwise unavailable to act when required, I appoint [Substitute full name], my [Relationship to you], of [Substitute address] (telephone: [Substitute telephone]), to act as my substitute attorney for personal care, with the same authority and subject to the same wishes, instructions, restrictions and limitations as set out in this document. A written declaration by the substitute that the first Attorney is unable or unwilling to act shall be sufficient evidence of that fact for any person relying on this document in good faith.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true,"displayConditions":[{"field":"5d60a6f4-a744-4bca-a4c2-4cf6ac2b2923","value":"1","type":"add","operator":"="}]},{"id":"c2afe180-7c5f-42a3-8a21-c71dd6b752a0","order":10,"text":"3. EFFECT AND DETERMINATION OF INCAPACITY","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","sectionNum":"S03"},{"id":"421ee539-6e35-4c87-9564-7d66abf5848a","order":11,"text":"This Power of Attorney for Personal Care takes effect [Effective trigger].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"ae50a302-6d9a-4127-94a3-a810ec0c3ec4","order":12,"text":"My mental incapacity to make a particular personal care or health care decision means that I am unable to understand the information that is relevant to making the decision, or unable to appreciate the reasonably foreseeable consequences of a decision or lack of decision. My incapacity shall be determined in accordance with the law applicable in the jurisdiction in which I am receiving care and, where practicable, confirmed in writing by a qualified physician, nurse practitioner or capacity assessor. My Attorney's authority is limited to those decisions which I am, at the relevant time, mentally incapable of making for myself.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"4615d4e7-e234-4c13-902a-1fef163e8741","order":13,"text":"So long as I am capable of making a particular decision, that decision remains mine alone, and nothing in this document derogates from my right to make my own decisions, or to communicate them by any means, while I remain capable. My Attorney's authority over any matter ceases if and when I regain capacity in respect of that matter.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"1dc5881c-d7bc-4b12-b7a0-38bb753e2e4a","order":14,"text":"4. AUTHORITY AND SCOPE OF PERSONAL CARE DECISIONS","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","sectionNum":"S04"},{"id":"21563e2f-4070-4c1b-a6ea-d0b94ae32cb7","order":15,"text":"Subject to the wishes, instructions and restrictions expressed in this document, I authorize my Attorney to do the following on my behalf:","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"29acbab8-528c-40b5-b63e-56cc1fc190fe","order":16,"text":"(a) to give, refuse or withdraw consent to any health care, medical or dental treatment, examination, diagnostic procedure, surgery, medication or course of treatment, and to consent to the withholding or withdrawal of treatment;","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true},{"id":"ea216740-2b12-4aa7-b41e-a6ba43a19473","order":17,"text":"(b) to make decisions concerning my admission to, discharge from, transfer between, or continued residence in a hospital, long-term care facility, retirement home, hospice, supportive living or other care setting;","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true},{"id":"1ff75fc8-a1d6-43fc-a7fc-3893c6f7452b","order":18,"text":"(c) to make decisions concerning my nutrition, hydration, personal hygiene, clothing, shelter, comfort, mobility, social contact and safety;","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true},{"id":"221f4442-e012-4132-b4bc-6260a4ec5a34","order":19,"text":"(d) to engage, instruct, supervise and discharge health practitioners, caregivers and personal support workers, and to enter into, vary and terminate agreements for my care;","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true},{"id":"f85d87d9-f3e7-4a6e-945d-f8d7b2432c29","order":20,"text":"(e) to take, defend, compromise or settle any legal proceeding relating to my personal care or health care; and","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true},{"id":"fa5901b2-c134-4c58-9231-68b51d3db835","order":21,"text":"(f) to take any step reasonably necessary or incidental to the exercise of the foregoing authority.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"d2f3fd4e-2f10-4379-868a-a90c816cf170","order":22,"text":"5. ACCESS TO PERSONAL HEALTH INFORMATION","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","sectionNum":"S05"},{"id":"caaa42cb-6be7-4930-9af4-5dffc0f52613","order":23,"text":"For the purpose of making informed decisions on my behalf, I authorize my Attorney to request, receive, review and copy any of my personal health information, medical records, diagnoses and prognoses, and to consent on my behalf to the collection, use and disclosure of that information. I direct every health practitioner, hospital, care facility and custodian of my health information to treat my Attorney as my authorized representative and to release such information to my Attorney to the same extent as it would release it to me. My Attorney may, in his or her discretion, share relevant information with members of my family and others involved in my care.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"089f34a6-430f-45fc-8410-0ba5deae36c8","order":24,"text":"6. STATEMENT OF WISHES — LIFE-SUSTAINING TREATMENT","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","sectionNum":"S06"},{"id":"8dd9c364-9f81-421f-bd32-f8397b355721","order":25,"text":"The following expresses my wishes and values regarding life-sustaining treatment. I direct my Attorney and any health practitioner to give effect to these wishes to the fullest extent permitted by law. My general wish is as follows:","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"19cbab58-1ed2-4936-8675-b9559e2a6dda","order":26,"text":"[Life-sustaining treatment preference]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"c42123b7-d042-4a31-b536-807278e145f3","order":27,"text":"I understand that medical circumstances cannot always be foreseen. Where my specific wishes do not clearly address the situation at hand, I direct my Attorney to make the decision that, in my Attorney's good-faith judgment, most closely reflects the values and wishes expressed in this document and is in my best interests.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"19b60f74-db99-4b4d-9266-f38e291d5ce2","order":28,"text":"7. SPECIFIC TREATMENT DIRECTIVES","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","sectionNum":"S07"},{"id":"841a9f63-898e-4737-bdfb-fbf30d080a7c","order":29,"text":"In addition to my general wishes above, I direct as follows with respect to the specific measures listed below, to be applied in light of my overall wishes and the prevailing medical circumstances:","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"92a64595-2019-4ce5-9746-33e0c4bcedb1","order":30,"text":"Cardiopulmonary resuscitation (CPR): [CPR preference]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true},{"id":"4b17407d-a4b7-4d31-acc7-e56eabc0477c","order":31,"text":"Artificial nutrition and hydration (feeding tube, intravenous fluids): [Nutrition/hydration preference]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true},{"id":"7e253064-a70f-4524-9deb-e5643bcce850","order":32,"text":"Mechanical ventilation and respiratory support: [Ventilation preference]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"5","cflou":false,"active":true},{"id":"2058d0fa-2dc3-4fdb-968d-fa06a91684a8","order":33,"text":"Pain relief and palliative care: [Pain management preference]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"65da2650-ef0f-44db-8d08-7037c96edd1f","order":34,"text":"8. MEDICAL ASSISTANCE IN DYING","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","sectionNum":"S08"},{"id":"1c9caf59-8d06-4483-b53f-1ada7a9041ec","order":35,"text":"I understand that medical assistance in dying (\"MAID\") is governed by the Criminal Code of Canada and applicable provincial and territorial law, and that, as the law currently stands, MAID generally requires the contemporaneous consent of a person who is capable of consenting, and cannot, except in the limited circumstances permitted by law (such as a valid advance consent or waiver of final consent arrangement), be authorized in advance by a substitute decision-maker. My wish regarding medical assistance in dying is as follows:","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"933efdb1-fca0-4641-9cfd-fcad280bffb5","order":36,"text":"[MAID preference]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"2d2855fc-6212-49f8-8125-1be0f66a4a53","order":37,"text":"Nothing in this document shall be construed as authorizing my Attorney to consent to medical assistance in dying on my behalf where the law does not permit such consent. This statement is intended to inform my Attorney, my family and my health practitioners of my values, and to be given effect only to the extent permitted by the law in force at the relevant time.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"0301fcac-1f32-4269-9317-41d8a6ca9da5","order":38,"text":"9. PLACE OF CARE AND LIVING ARRANGEMENTS","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","sectionNum":"S09"},{"id":"a2631f62-a202-40f9-ac91-2fc86bb3cfa8","order":39,"text":"My wishes regarding where and how I receive care are as follows: [Place of care preference] I direct my Attorney to give effect to these wishes so far as it is safe, practical and consistent with my care needs and available resources to do so, and to prefer the least restrictive and least intrusive arrangements that adequately meet my needs.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"eb2e38df-7203-43e7-b934-45d980294c02","order":40,"text":"10. SPECIFIC RESTRICTIONS AND CONDITIONS","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","displayConditions":[{"field":"6b8d8892-501d-485d-b48d-dc888f15e37e","value":"1","type":"add","operator":"="}],"sectionNum":"S10"},{"id":"6d86364e-c8bd-406e-a8b5-88be95d5c6f7","order":41,"text":"Notwithstanding any other provision of this document, I impose the following specific restrictions and conditions on the authority of my Attorney, which my Attorney and my health practitioners shall observe to the fullest extent permitted by law: [Your specific restrictions]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true,"displayConditions":[{"field":"6b8d8892-501d-485d-b48d-dc888f15e37e","value":"1","type":"add","operator":"="}]},{"id":"9015ee1f-5168-4a34-bcd8-0a138a02e2b0","order":42,"text":"11. ORGAN AND TISSUE DONATION","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","displayConditions":[{"field":"a2163994-142d-4733-bc4c-84b3f4baca2e","value":"all","type":"add","operator":"="},{"field":"a2163994-142d-4733-bc4c-84b3f4baca2e","value":"specified","type":"add","operator":"="}],"sectionNum":"S11"},{"id":"9aab5d3c-f694-4160-b724-ba804822214c","order":43,"text":"Upon my death, it is my wish to donate all of my organs and tissue that are suitable for the purposes of transplantation, therapy, medical research or education, as permitted by law. I direct my Attorney and my family to give effect to this wish and to cooperate with the relevant donation authorities.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true,"displayConditions":[{"field":"a2163994-142d-4733-bc4c-84b3f4baca2e","value":"all","type":"add","operator":"="}]},{"id":"17597d2e-a92b-46a2-a8e2-e9520524ce7c","order":44,"text":"Upon my death, it is my wish to donate [Organs or tissue to donate] for the purposes of transplantation, therapy, medical research or education, as permitted by law. I direct my Attorney and my family to give effect to this wish and to cooperate with the relevant donation authorities.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true,"displayConditions":[{"field":"a2163994-142d-4733-bc4c-84b3f4baca2e","value":"specified","type":"add","operator":"="}]},{"id":"20a4b496-8a19-42eb-b17d-2b8d6c0c0aaf","order":45,"text":"12. RELIGIOUS, SPIRITUAL AND CULTURAL WISHES","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","displayConditions":[{"field":"ef8fcc65-ab28-4925-9dc8-e4784b1116d9","value":"1","type":"add","operator":"="}],"sectionNum":"S12"},{"id":"80aea120-6f23-4992-8eee-7602d824e8ce","order":46,"text":"My religious, spiritual and cultural beliefs are important to me and I wish them to be respected in the course of my care and at the end of my life. I direct my Attorney to take these beliefs and observances into account when making decisions on my behalf, to arrange for appropriate spiritual or religious support where reasonably possible, and in particular to observe the following: [Your religious, spiritual or cultural wishes]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true,"displayConditions":[{"field":"ef8fcc65-ab28-4925-9dc8-e4784b1116d9","value":"1","type":"add","operator":"="}]},{"id":"2274404b-b52f-499e-81cc-b64ba0c11272","order":47,"text":"13. ADDITIONAL WISHES AND INSTRUCTIONS","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","sectionNum":"S13"},{"id":"9377268c-d951-43ef-afdc-148833fa76ad","order":48,"text":"The following additional wishes, values and instructions are to guide my Attorney and those caring for me: [Additional wishes — leave blank if none]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"2c2d2255-bb8c-4408-9ea3-b13bcbaa5aeb","order":49,"text":"14. GUIDANCE AND STANDARD FOR THE ATTORNEY","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","sectionNum":"S14"},{"id":"2aeb8b88-673b-4335-a708-92f8914c2599","order":50,"text":"In exercising the authority granted under this document, my Attorney shall act diligently, honestly, in good faith and for my benefit. My Attorney shall, so far as reasonably possible, explain his or her powers and duties to me, encourage my participation in decisions affecting me, foster regular personal contact between me and supportive family members and friends, and consult from time to time with such persons and with my health practitioners.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"3b78a85f-e6bc-4ad5-8701-3c6279783e07","order":51,"text":"Where my prior expressed wishes apply to a decision, my Attorney shall act in accordance with those wishes. Where no applicable wish exists, my Attorney shall act in my best interests, taking into account my values, beliefs and the wishes expressed in this document, and choosing the course that least restricts my freedom and dignity while adequately meeting my needs.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"fd6bbf02-3261-4838-a432-6a85c8e8c288","order":52,"text":"If a disagreement arises between my Attorney and any member of my family or any health practitioner concerning my care, my Attorney's decision shall prevail to the extent permitted by law, provided it is consistent with this document; and I direct that reasonable efforts first be made to resolve the disagreement through discussion and, where appropriate, mediation or the assistance of an institutional ethics committee before resorting to any tribunal or court.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"57c50231-aca5-4b0f-88d2-979ba269de08","order":53,"text":"15. RESIGNATION OF THE ATTORNEY","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","sectionNum":"S15"},{"id":"82eef5a4-8ecc-47f2-9a64-5f968a2072d1","order":54,"text":"My Attorney (or substitute attorney) may resign by giving written notice to me and, if I am then incapable, to any substitute attorney named in this document and to the person or facility then responsible for my care. A resigning attorney shall take reasonable steps to ensure continuity of my care and to deliver any records and information in his or her possession to the person who succeeds to the authority under this document.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"1c7a2076-3324-4746-84cc-ff81acab77e6","order":55,"text":"16. COMPENSATION OF THE ATTORNEY","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","sectionNum":"S16"},{"id":"fb2ff5f1-ae82-416b-8a58-b2e19d33cd74","order":56,"text":"[Compensation arrangement] My Attorney shall in all cases be entitled to be reimbursed from my assets for reasonable expenses properly incurred in carrying out the duties under this document.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"79b50b83-1fa4-4278-b527-f67652672d47","order":57,"text":"17. REVOCATION AND AMENDMENT","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","sectionNum":"S17"},{"id":"9f43f98a-05e6-4137-a563-c7e0577e96fc","order":58,"text":"I hereby revoke any and all powers of attorney for personal care, advance directives, living wills and similar instruments respecting my personal care or health care that I have previously made. This document represents my current and complete wishes with respect to my personal care and health care.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"1c95c53f-3db0-4cd2-84fb-22afedab9962","order":59,"text":"I may revoke this document at any time while I am capable of doing so, by a written instrument of revocation, by making a later power of attorney for personal care, or by any other means permitted by the applicable law. I may amend this document only by a written instrument signed and witnessed in the same manner as this document. No revocation or amendment shall affect the validity of any act done in good-faith reliance on this document before notice of the revocation or amendment is received.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"d4ba4786-30f8-4ae9-96c6-1fba12cef155","order":60,"text":"18. CUSTODY OF ORIGINAL AND COPIES","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","sectionNum":"S18"},{"id":"771b3728-ac93-448f-b9f1-d64b8faa52c5","order":61,"text":"The original of this document is kept at the following location: [Where the original is kept]. I direct that a copy of this document be provided to my Attorney, to any substitute attorney, and to my primary health practitioner, and that a copy be treated as having the same effect as the original for all purposes for which a copy is permitted by law. Any person may rely on a copy of this document unless they have actual notice of its revocation.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"0975f02c-1aaa-4ae4-9c41-9c6e57fe7098","order":62,"text":"19. LIMITATIONS, SEVERABILITY AND INTERPRETATION","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","sectionNum":"S19"},{"id":"d431f7af-9adb-480e-a6a7-fe3790d903d5","order":63,"text":"If any provision of this document is held to be invalid, unenforceable or contrary to law, that provision shall be severed and the remaining provisions shall continue in full force and effect. The invalidity of any one instruction shall not affect the validity of my appointment of my Attorney or of my other wishes.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"a16d2f13-3910-4003-a260-9a4fb286002f","order":64,"text":"Words importing the singular include the plural and vice versa, and words importing a gender include all genders. The headings in this document are for convenience of reference only and do not affect its interpretation. No health practitioner, attorney or other person who acts in good-faith reliance on this document, or who follows the directions of my Attorney given under it, shall incur any liability by reason of having done so.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"f0508768-d0e7-4922-adc0-d69b7989bfdf","order":65,"text":"20. GOVERNING LAW","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20","sectionNum":"S20"},{"id":"d3b000a0-1002-4148-8bb6-70ee635e83ec","order":66,"text":"This document shall be governed by and construed in accordance with the laws of [Province or territory] and the federal laws of Canada applicable therein. It is my intention that this document be given effect in any jurisdiction in which I may require care, to the fullest extent permitted by the applicable law of that jurisdiction.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"342043bb-8882-4b9c-a9f0-c30dc7896b70","order":67,"text":"EXECUTION","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20"},{"id":"e7afa671-2a97-4a01-b6c3-dc3b0248230b","order":68,"text":"IN WITNESS WHEREOF I have signed this Power of Attorney for Personal Care and Advance Directive at [City], on [Date], declaring it to be my free and voluntary act made while of sound mind and after due consideration.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"30","cflou":false,"active":true},{"id":"c54300ca-4369-4eeb-aa91-211e7dd86a9f","order":69,"text":"_______________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"0","cflou":false,"active":true},{"id":"35caf26d-c061-4792-b3b6-982762afa847","order":70,"text":"[Full legal name], Grantor","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"30","cflou":false,"active":true},{"id":"cf41b756-3b14-485f-bb97-6704fc94376d","order":71,"text":"Signed by the Grantor in our joint presence, and by us in the presence of the Grantor and of each other. We, the undersigned witnesses, each declare that the Grantor signed this document in our presence, that the Grantor appeared to us to be of the age of majority, of sound mind, and acting freely without duress, undue influence or coercion, and that neither of us is the appointed Attorney or substitute attorney, the spouse or partner of the Grantor or of any attorney, a person whose consent would be required to a personal care decision for the Grantor, a child of the Grantor, or a person under the age of majority.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"e01fa8a4-8324-4f2a-a5ac-f00a469a329c","order":72,"text":"Witness 1","fontSize":"14","textAlign":"left","bold":true,"underline":false,"marginBottom":"5","cflou":false,"active":true},{"id":"65259f0b-b01a-477f-93a3-b317fd67d66b","order":73,"text":"_______________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"0","cflou":false,"active":true},{"id":"4dcdac67-97f5-4c65-86f1-2eaaa3cbe9f5","order":74,"text":"Name: [Witness 1 name]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"0","cflou":false,"active":true},{"id":"58f873d5-4ee7-4e4a-898f-8fdf050f5063","order":75,"text":"Address: [Witness 1 address]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"6eaa80af-3d38-4da8-81e0-8bc24f6bd451","order":76,"text":"Witness 2","fontSize":"14","textAlign":"left","bold":true,"underline":false,"marginBottom":"5","cflou":false,"active":true},{"id":"90722c9f-e4db-42ca-9977-8c367e34fa9a","order":77,"text":"_______________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"0","cflou":false,"active":true},{"id":"f036b980-9437-480d-8388-15d4a75a927f","order":78,"text":"Name: [Witness 2 name]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"0","cflou":false,"active":true},{"id":"4bb15465-31cb-4649-a337-8adb387af620","order":79,"text":"Address: [Witness 2 address]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"3b2b156e-ff4c-4f3c-a885-77cf6fa0e410","order":80,"text":"Note: The formal requirements for a valid power of attorney for personal care — including the number and eligibility of witnesses and any prescribed form of attestation — vary by province and territory. The Grantor should ensure that this document is signed and witnessed in accordance with the law of the applicable jurisdiction, and should consider obtaining independent legal advice.","fontSize":"11","textAlign":"left","bold":false,"underline":false,"marginBottom":"0","cflou":false,"active":true}]