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By September 30, 2022June 10th, 202421 Comments

Using this or a document like it may help you to avoid some of the ill deeds that hospital doctors perpetrated on Rob Garmong’s wife and Scott Schara’s daughter. Be sure the providers acknowledge receipt in writing when you go to the hospital. Write down their names. Notarization is nice but may not be necessary.


I, —————————————- residing at ——————————————-, make, constitute and appoint ———————————————————- residing at —————————————————(hereinafter referred to as my “Health Care Representative”), my true and lawful attorney-in-fact to be my Health Care Representative with respect to all health care matters except the specific provisions following, upon the terms and conditions hereinafter set forth.


1. IN NO CASE shall a vaccine of any kind–Covid, influenza, or any other–be administered to _________________ And in NO CASE shall Remdesivir be administered to ________________. And in NO CASE shall sedation and intubation for Covid treatment be undertaken unless the Healthcare Representative gives WRITTEN approval and observes the process.

And in NO CASE shall __________________ be considered for hospice, end-of-life care, or “Do Not Resuscitate (DNR) unless my health care representative agrees and consents and signs a written statement to that effect.

2.     IF TRANSFUSION IS RECOMMENDED BY PHYSICIAN PERSONNEL, it will NOT be permitted under any circumstances unless one of the three following criteria is met:

  • Hemoglobin is less than 15, and hematocrit is less than 5

  • The Healthcare Representative in this document directs the transfusion to occur.

  • Donor blood has been obtained from someone who has never been Covid vaccinated.

3.     The Healthcare Representative will at all times have absolute power to discharge _______________from the hospital against medical advice, under any circumstances whatsoever, even if hospital personnel determined that he is dying,

All possible efforts must be undertaken to obtain blood from a donor of the Healthcare Representative’s choice.

3. I desire that my wishes with respect to all health care matters be carried out through the authority given to my Health Care Representative under this Health Care Power of Attorney despite any contrary feelings, beliefs, or opinions of other members of my family, relatives or friends, or doctors or other hospital personnel. I have thoroughly discussed my personal preferences and desires with my Health Care Representative and his or her successor. I am fully satisfied that each will know best what I would wish and I have the utmost faith and confidence in their respective good judgments.

4. In exercising the authority herein given to my Health Care Representative, my Health Care Representative should try to discuss with me the specifics of any proposed health care decision if I am able to communicate in any manner whatsoever, even by blinking my eyes. I hereby further direct and instruct my Health Care Representative that if I am unable to give an informed consent to my medical treatment or if the physician(s) providing me with medical care determine that I lack capacity to make a particular health care decision, my Health Care Representative shall make such health care decision for me based upon any treatment choices or other desires that I have previously expressed while competent, whether under this Health Care Power of Attorney or otherwise.

My Health Care Representative is authorized to do any one or more of the following:

(i) To sign on my behalf any documents necessary to carry out the authorizations described below, including waivers or releases of liabilities required by any health care provider;

(ii) To give or withhold consent to any medical care or treatment, to revoke or change any consent previously given or implied by law for any medical care or treatment, and to arrange for my placement in or removal from any hospital, convalescent home or other health care institution;

5. The rights and authority conferred on my Health Care Representative herein appointed shall include, but is by no means limited to, the right to receive information and reports from all treating physicians, other health care professionals, health care institutions, etc., regarding proposed health care, surgery, or any other aspect of my medical treatment; the right to receive and review my medical records and information to the same extent that I am entitled to and to disclose or consent to the disclosure of my medical records to others; to contract on my behalf for any health care related service or facility (without my Health Care Representative incurring personal financial liability for such contracts); and to hire and fire physician, social service, and other support personnel responsible for my care.

6. This instrument is to be construed and interpreted as an “advance directive for health care” as such term is defined in California state statute. In determining the rights of my Health Care Representative herein appointed, the enumeration of the specific items, rights, acts or powers set forth herein is not intended to nor does it limit, and it is not to be construed or interpreted as limiting, the specific power of my Health Care Representative to do and perform any and all acts with respect to my health care which I would be able to perform if I were competent and able to do so and as are within the bounds of authority granted by the Act.

7. In the event ——————————— shall become unable to act as my Health Care Representative hereunder for any reason whatsoever, including, but not limited to, death, incapacity, or resignation, then I do hereby make, constitute and appoint ———————————- as successor Health Care Representative to serve in the place of the Health Care Representative first above named.

8. No person who relies in good faith upon any representations by my Health Care Representative or any successor Health Care Representative shall be liable to me, my estate, my heirs or my assigns for recognizing the Health Care Representative’s authority. The directions of my Health Care Representative shall be binding in all respects upon all those involved in my care. My Health Care Representative and all those acting upon his or her directions shall be entitled to indemnification from my estate in connection with all claims asserted against them unless the directions given and relied on are wholly inconsistent with my intentions as expressed above.

9. If a guardian of my person should for any reason be appointed, I hereby nominate my Health Care Representative _________________, and as alternate ________________ named above.


(A) I hereby revoke any prior Health Care Power of Attorney.

(B) This Health Care Power of Attorney is intended to be valid in any jurisdiction in which it is presented.

(C) My Health Care Representative shall not be entitled to compensation for services performed under this Health Care Power of Attorney, but he or she shall be entitled to reimbursement for all reasonable expenses incurred as a result of carrying out any provisions of this Health Care Power of Attorney.

(D) In the event of any disagreement between my Health Care Representative and my attending physician concerning my decision-making capacity or the appropriate interpretation and application of the terms of this Health Care Power of Attorney to my course of treatment, it is my wish and desire that such disagreement be resolved in accordance with the written direction of my Health Care Representative.

(E) The powers delegated under this Health Care Power of Attorney are separate so that the invalidity of any one (1) or more shall not affect any others.

11. By this instrument, I intend to create a durable power of attorney effective upon and only during any period of incapacity in which, in the opinion of (i) my Health Care Representative and (ii) one or more other confirming physicians, I lack capacity to make a particular health care decision (i.e. “Period of Incapacity”). The rights, powers, and authority of my Health Care Representative herein appointed shall commence and shall be in full force and effect upon any such determination as to the commencement of a Period of Incapacity, and such rights, powers and authority shall remain in full force and effect from the above-mentioned date until such time as I have regained my capacity to make such health care decision(s) or until my death, as the case may be; PROVIDED, HOWEVER, that this Health Care Power of Attorney may be revoked by me by a written instrument duly acknowledged before a notary public or by such other manner as shall be allowed under the Act; and PROVIDED, FURTHER, that my regaining capacity following any Period of Incapacity shall not be treated as an event causing the revocation of this Health Care Power of Attorney and this Health Care Power of Attorney shall be construed as if such Period of Incapacity never occurred.



Each of the undersigned declares that the person who signed this Health Care Power of Attorney did so in the presence of the undersigned; that said person is personally known to the undersigned and appears to be of sound mind and acting willingly and free from duress or undue influence; and that each of the undersigned and the person executing this Health Care Power of Attorney is 18 years of age or older; and the undersigned is not designated as the person’s Health Care Representative under this Health Care Power of Attorney.

______________________________ residing at





______________________________ residing at




I hereby certify that on [date ] __________________________ personally came before me and acknowledged under oath, to my satisfaction, that [he/she ] is the person named in and personally signed this Health Care Power of Attorney, and that [he/she ] signed, sealed and delivered this Health Care Power of Attorney as [his/her ] act and deed for the uses and purposes therein expressed.


I simply modified this document without attorney help. It is more prudent to consult a lawyer.

So many false positives happen with the Covid tests that people have been admitted to the hospital for something else and found themselves falsely diagnosed with Covid and treated with hazardous and sometimes deadly therapies.

Intubation is rarely indicated for Covid and frequently leads to death. Some doctors say that micro-clots in the fingers due to the spike protein may deceive the oxygen measurement (saturation) and have led to improper early intubation.

Remdesivir is a dangerous, ineffective drug that causes fatalities in a quarter to half of patients. It should never be used. In a series of criminal actions, Fauci and others hustled it through the approval process.

Hospice, end-of-life care, and “Do Not Resuscitate (DNR) can all be used by hospital personnel to end lives. Hospice has a peculiar business model that allows for thirty days of fees. In some areas, the providers are reimbursed for the full thirty days, even if the patient lives only one day. This can be abused. Agree to these provisions only if you are sure your loved one is dead.

Refuse blood transfusion if your life is not at risk. The US blood supply is contaminated with spike protein from those who got the vax. The risks from this are unknown but likely significant. You may be able to arrange a private donation from an unvaccinated person if you think ahead.

If the patient is old and frail, my blood transfusion criteria above may be too strict. Learn about this and make your own decision. Think ahead and get advice. It may be too late when you are sick.

Given what we know, all vaccines do more harm than good and must be taken off the market. The Covid jab is beyond ridiculous. See my ofter posts.

You may need to bring an attorney and local sheriff to the hospital to get your loved one out.

“LEGAL” DISCLAIMER: This is for informational purposes only. Use at your own risk. Check this with an attorney and doctor that you trust. Keep a copy. I am retired and neither practicing law nor medicine. Copy whatever you want from this at your own risk.


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