(1) "Health care provider" means an individual licensed, certified, or otherwise authorized or permitted by the law of California or of any other jurisdiction to provide health care in the ordinary course of business or practice of a profession who is providing health care to the registrant.(b) The following definition shall apply for purposes of Probate Code section 4801:
(2) "The public guardian" means a public official of any jurisdiction who is serving in his or her official capacity as the guardian or conservator for the registrant.
(3) "The legal representative of the registrant" means an individual who is either:(A) serving as the guardian or conservator for the registrant pursuant to an order of a court of any jurisdiction; or
(B) designated in a current written advance health care directive or similar written document registered with the Secretary of State to make health care decisions for the registrant.
(1) "Other authorized persons" means the legal representatives of registrants as defined in Section 22610.1(a)(3) of Article 1, Chapter 14, Division 7, Title 2, California Code of Regulations.NOTE: Authority cited: Sections 4800(a), 4801, Probate Code.
(1) Whether the form submitted relates to a new registration, an amendment to a prior registration, a revocation of a prior registration or notification regarding an amendment to or revocation of a previously-filed written advance health care directive;
(2) Whether the written advance health care directive or amendment to a previously-filed written advance health care directive is attached to the form or, in the alternative, whether the form provides notification of the intended place of deposit or safekeeping of a written advance health care directive or amendment to a written advance health care directive;
(3) The registrant’s name, address, date and place of birth, and the name and telephone number of the agent and any alternative agent;
(4) At least one of the following:A. The registrant’s social security number, or
B. The registrant’s driver’s license number, or
C. The registrant's individual identifying number established by law.
(5) Intended place of deposit or safekeeping of the written advance health care directive or amendment to the written advance health care directive to which the form relates, if applicable;(c) The registrant shall submit the completed form to the address indicated on the form, along with the required fee, if any.
(6) The signature and printed name of the registrant;
(7) The date the form is signed by the registrant.
(1) The name, address and telephone number of the requestor;NOTE: Authority cited: Sections 4800(a), 4801, Probate Code.
(2) Credible evidence establishing the identity of the requestor. In determining whether the identity of the requestor is established by credible evidence, the Secretary of State may consider requestor’s use of business letterhead in making the request, a copy of a driver’s license or identification card issued by the California Department of Motor Vehicles, a copy of a United States passport, or copies of other credible identification documents;
(3) A statement by the requestor establishing his or her authority to receive the information requested;
(4) The identity of the individual for whom the information is requested. In establishing the identity of the individual for whom the information is requested, the Secretary of State may consider the presentation by the requestor of any information contained in or on the filed registration form, including a file number, date of birth, place of birth, social security number, driver’s license number or other identifying number; and
(5) A statement setting forth the reason the information is needed.