Montana's End-of-Life Registry
INSTRUCTIONS: MONTANA'S END-OF-LIFE REGISTRY
Montana's End-Of-Life Registry provides an online resource for residents of the state to store their advance directives. This registry is discussed in an information document which can be obtained from the website maintained by the Montana State University Extension.
Montana's End-Of-Life Registry Step 1: The first page contains general information about advance directives.
Montana's End-Of-Life Registry Step 2: The second page contains a consumer registration agreement, used to indicate your desire to store an advance directive in the Montana End-Of-Life Registry. In the first blank box of Section A, enter your prefix.
Montana's End-Of-Life Registry Step 3: In the second blank box, enter your first name.
Montana's End-Of-Life Registry Step 4: In the third blank box, enter your middle name or initial.
Montana's End-Of-Life Registry Step 5: In the fourth blank box, enter your last name.
Montana's End-Of-Life Registry Step 6: In the fifth blank box, enter your suffix.
Montana's End-Of-Life Registry Step 7: In the sixth blank box, enter your gender.
Montana's End-Of-Life Registry Step 8: In the seventh blank box, enter your date of birth.
Montana's End-Of-Life Registry Step 9: In the eight blank box, enter your mother's maiden name.
Montana's End-Of-Life Registry Step 10: In the ninth blank box, enter your Social Security number.
Montana's End-Of-Life Registry Step 11: In the tenth blank box, enter your phone number.
Montana's End-Of-Life Registry Step 12: In the eleventh blank box, enter your mailing street address.
Montana's End-Of-Life Registry Step 13: In the twelfth blank box, enter your city.
Montana's End-Of-Life Registry Step 14: In the thirteenth blank box, enter your state.
Montana's End-Of-Life Registry Step 15: In the fourteenth blank box, enter your zip code.
Montana's End-Of-Life Registry Step 16: In the fifteenth blank box, enter your county.
Montana's End-Of-Life Registry Step 17: In the sixteenth blank box, enter your country.
Montana's End-Of-Life Registry Step 18: In Section B, indicate whether you are requesting Standard Privacy or Higher Privacy with a check mark.
Montana's End-Of-Life Registry Step 19: Indicate with a check mark whether you wish to store, replace or remove an advance directive from the registry, or whether you are requesting a replacement wallet card.
Montana's End-Of-Life Registry Step 20: Enter your signature on the first blank line of Section C and the date on the second blank line.