Skip to main content


By October 2, 2022June 10th, 20248 Comments

Trash the old one. I got the hemoglobin and hematocrit numbers mixed up, sorry. (Thanks, Mark!)

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 that providers acknowledge written receipt when you go to the hospital and 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 any 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 health care representative agrees and consents IN WRITING. And in NO CASE shall ________________________ be considered for hospice or end of life care unless the health care representative agrees and consents IN WRITING. 

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

A) Hemoglobin is less than 5, and hematocrit is less than 15

B) The Healthcare Representative in this document is consulted and directs the transfusion to occur IN WRITING.

All possible efforts must be undertaken to obtain blood from a donor of the Healthcare Representative’s choice. The Healthcare representative will have the final decision authority about any blood transfused.

3. The Healthcare Representative will at all times have ABSOLUTE POWER to discharge ____________________ from the hospital against medical advice under any circumstances whatsoever.

4. I desire that my wishes concerning 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 doctors, family members, relatives, or friends. I have thoroughly discussed my personal preferences and desires with my Health Care Representative and their 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 sound judgments.

In exercising the authority herein given to my Health Care Representative, my Health Care Representative should discuss with me the specifics of any proposed health care decision if I can 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 informed consent to my medical treatment or if the physician(s) providing me with medical care determine that I cannot 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 healthcare 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 healthcare professionals, healthcare institutions, etc., regarding proposed health care, surgery, or any other aspect of my medical treatment. It shall include 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. It shall include the ability to contract on my behalf for any healthcare-related service or facility (without my Health Care Representative incurring personal financial liability for such contracts); and to hire and fire physicians, social services, 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 a term is defined in California 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 that 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 is resolved by 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 powers 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 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.


So many false positives happen with the Covid tests that you could be admitted to the hospital for something else and find yourself falsely diagnosed with Covid and treated with hazardous therapies.

Remdesivir is a dangerous, ineffective drug that causes fatalities in a quarter to half of the patients. Fauci hustled it through the approval process. It should never be used for anything. 

If you are old or frail, my blood transfusion criteria above may be too conservative and you may need a transfusion to save your life. Learn about the issues and make your own decision. Think ahead and get advice, for it may be too late when you are sick.

Given what we know, every vaccine does more harm than good and all should be taken off the market. Paraphrasing Toby Rogers, the Covid jab is beyond ridiculous. See my other chapters. 

You may have to bring an attorney and/or a local sheriff to the hospital to discharge your loved one. 

“LEGAL” DISCLAIMER: This is for informational purposes only. Use at your own risk. Check it with an attorney and doctor that you trust and modify it as they direct and your best judgment advises you. Give them signed copies and keep another one. I am retired and neither practice law nor medicine.


Leave a Reply