Personal Representative Designation Form - The privacy of your child or the child in your care is important to us. Web designate a personal representative. Make decisions about your health care. Web personal representative designation form. Web by completing this form you are informing us of your wish to designate the named person as your personal representative. Web in addition to these formal designations of a personal representative, the rule at 45 cfr 164.510 (b) addresses. Use this form to identify a person who can:
Web in addition to these formal designations of a personal representative, the rule at 45 cfr 164.510 (b) addresses. Make decisions about your health care. Web personal representative designation form. Web by completing this form you are informing us of your wish to designate the named person as your personal representative. Web designate a personal representative. Use this form to identify a person who can: The privacy of your child or the child in your care is important to us.