- Part 3 of 4 -
Patient Advocate Agreement
A patient advocate agreement can help you and your advocate decide how your advocate can best provide you with the support you need. Please read through this information and fill out the form at the bottom of this page.
For tips on advocating for yourself and others go to: www.safetoask.ca and www.mips.ca
CancerCare Manitoba - Interlake-Eastern Regional Health Authority - Northern Health Region - Prairie Mountain Health - Southern Health-Santé Sud - Winnipeg Regional Health Authority
Instructions to Patient:
1. Discuss the information with your advocate(s) before you complete this agreement.
2. Complete and sign the agreement.
3. Have your patient advocate sign this agreement.
4. This form will be submitted to Daughter On Call and we will add it to your file.
5. Review this agreement from time to time as your wishes may change.