END-OF-LIFE DECISION MAKING

SENIOR PARTNERS IN HEALTH:
COMMUNICATING WITH YOUR DOCTOR ABOUT
ADVANCE CARE PLANNING AND END-OF-LIFE DECISION MAKING

THE PROJECT PACKET INCLUDES:

Full Narrative Report, the detailed story complete with rationale, background, process and findings.
Executive Summary, a brief overview of the project report, available for ?promotional? distribution.
Facilitator Training Manual, a detailed step-by-step guide to conducting the two-hour interactive program for seniors, and the six-hour facilitator workshop. Extensive resource list and appendices with sample materials for use in implementing the program are included.
Training Video, a fifteen-minute video of the four vignettes illustrating the models of doctor-patient relationships, to be used in conjunction with the training manual.

COST: $85.00 (includes shipping and handling)

The NEW YORK CITIZENS? COMMITTEE ON HEALTH CARE DECISIONS, INC. (NYCCHCD) is a non-profit, non-partisan grassroots initiative providing an impartial forum for public discussion of critical health care issues. The Committee?s goal is to heighten public and professional understanding of these issues and to foster informed participation in both individual care and the formation of public policy. The Committee has no hidden agenda; we seek only to raise issues and explore options.

SENIOR PARTNERS IN HEALTH, a two-year project funded by the Open Society Institute: Project on Death in America, focuses on empowering seniors to become active participants in their doctor/patient working relationship, advance care planning and how they interact to affect the medical decision-making process.

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ORDER FORM

Please send _____ packet(s) (@ $85.00 each) of the Senior Partners in Health Project.?

Name:_____________________________________?
Organization:________________________________
__________________________________________
Address:___________________________________
City:______________________________________
State/Zip: __________________________________
Phone: (_______)____________________________

Enclosed is a check payable to
NYCCHCD for $__________.

Mail this form to:
New York Citizens? Committee on
Health Care Decisions, Inc.
39 Broadway, Suite 200
New York, NY 10006

____Please send me additional information
about the New York Citizens Committee
on Health Care Decisions, Inc.

Tel:? 212)586-4638; Fax: (212) 586-4699