Brain Bank Advanced Directives Checklist

We invite you to complete several forms to make certain that your personal wishes and long-term planning needs are addressed. It is important to take these steps NOW so your health care and financial decisions about the future can guide your family and health care providers in following your wishes. If you have questions about these forms [called advance directives], please call Carol Moskowitz at (212) 305-5779.

Please review the following checklist:

  • Health Care Proxy
    This is the simplest form to complete. You can do it without an attorney or a notary. The purpose of this form is for you to name the person who will make health care decisions for you in the event that you cannot do so yourself. A copy of the New York State form is attached. The original should be kept with you and 3 copies made. Give a copy to your health care proxy, to our office and to your GP/internist to be kept as part of your medical records.
  • Entitlements or Benefits
    Based on your finances, you may be eligible for various government benefit programs. If you have not done so already, you should see an attorney for financial planning purposes.
  • Durable Power of Attorney
    Everyone should consult an attorney to prepare a durable power of attorney. This is where you name the person who will make financial decisions for you if you are not able to do so.
  • Living Will
    A living will should also be completed. This consists of specific instructions for your health care proxy if you are not able to make your own health care decisions. If you want an advance directives workbook that includes a sample living will, please call Carol Moskowitz
  • Brain Donation
    This is the most significant gift that a person can make. A Letter of Intent is attached. Please read this carefully and consider making this donation to neuroscience research for your family. You may want to decide for yourself or make a decision in consultation with your family and your doctor. If you agree, please complete your letter of intent and send it to us. Please view our website for more information about the research done at our Center, consider planning advance directives.