1. Multiple Decision Makers: Section to be included when more than one person is being authorized to make medical decisions, defining how they must act (jointly or severally)

2. Specific Medical Conditions: To be included when the principal has specific medical conditions that require special consideration or instructions

3. Religious or Cultural Preferences: Section addressing any specific religious or cultural considerations that should guide medical decisions

4. Revocation Clause: Details how the consent can be revoked, to be included if the principal wants explicit revocation procedures

5. Interstate Recognition: To be included if the principal frequently travels between states, addressing recognition of the consent in different jurisdictions

6. Emergency Contact Information: Optional section listing additional emergency contacts beyond the authorized decision-makers

1. Schedule 1 - Authorized Medical Treatments: Detailed list of specific medical treatments and procedures covered by the consent

2. Schedule 2 - Excluded Treatments: List of any medical treatments specifically excluded from the consent

3. Schedule 3 - Current Medical Information: Summary of the principal's current medical conditions, medications, and allergies

4. Appendix A - Capacity Assessment Certificate: Medical practitioner's certificate confirming the principal's capacity at the time of signing

5. Appendix B - Identification Documents: Copies of identification documents for all parties

6. Appendix C - Advanced Care Directives: Any existing advanced care directives or preferences to be considered alongside this consent