Page 278 - Demo

BOX TWO - YOUR WISHES
Record here any information which might be helpful to explain your wishes and instructions.
I am a religious Sister living under vows in a community. The community is [Name and address of the institute].
The vows I have taken include a vow of poverty. The Community is therefore responsible for my maintenance and also my welfare. It is therefore of fundamental importance to me that my wishes are respected in respect of those individuals I ask to be consulted and informed regarding my health and welfare as set out in Box G below.
I wish the Roman Catholic Chaplain to be advised if I am admitted to a hospital or a hospice.
When I am nearing death, I wish a Roman Catholic Priest to be called to administer the Sacraments to me.
BOXTHREE– DETAILS OF YOUR DOCTOR
Doctor's name
Doctor's address
Doctor's telephone
I have discussed this Living Will with my doctor
YES/NO
274 Appendix E