Provider Authorization and Obligations
- Vermont Advance Directive Registry

Definitions

An advance directive is a legal document that conveys a person's wishes regarding their health care treatment and end of life choices, should they become incapacitated or otherwise unable to make those decisions. The document may include an appointment of an agent, identification of a preferred primary care physician, healthcare wishes, anatomical gifts, disposition of remains, terminal care document or similar documents.

The term provider is used by the registry to include health care providers, health care facilities, residential care facilities, probate court officials, procurement organizations, funeral directors, crematory operations and cemetary officials.

An authorized provider is an individual or organization that has been approved by the Department of Health for unlimited secure access to the registry.

A registrant is an individual who has submitted an advance directive or an Advance Directive Locator form to the Registry, and received written confirmation that the advance directive is registered.

Vermont Advance Directive Registry (Registry) is a secure, web-based database to which individuals may submit, at no charge, an advance directive or an Advance Directive Locator form and other documents which amend, suspend or revoke an advance directive. The documents are electronically stored and may be accessed by providers through the Internet or by telephone.

How to Become an Authorized Provider

Complete and submit the Provider Access Agreement and Provider Access Application form to the Vermont Department of Health at:

Vermont Advance Directive Registry
Vermont Department of Health
108 Cherry Street, Room 304
P.O. Box 70
Burlington, VT 05402-0070

Vermont Department of Health will review and approve applications. Once approved, the Registry will contact the provider with instructions and registry account number.

Providers issued a registry user account shall

Notification of Changes

Providers are obligated to notify the registry when they become aware of changes to an advance directive.

To notify the registry, a provider shall complete a Provider Notification Form and submit it to the registry by:

Mail or FAX

Technical Support

Routine help and questions are addressed by sending an e-mail message to the registry at support@uslivingwillregistry.com.

Business hours telephone support is available Monday to Friday, 9:00 am to 5:00 pm EST, by calling (908) 325-2525.

Emergency support during non-business hours is available by calling (888) 548-9455.

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