Summit Endoscopy Center, LLC

1265 Highway 54 West Suite 401 Fayetteville, GA 30214

Advanced Directives

Definition; An “Advance Directive” is a legal document in which an individual describes his/her personal health care choices should the time ever come that she/he is unable to speak for her/himself, and there is little hope of recovery. The most common forms of Advance Directives are the Living Will and the Durable Power of Attorney for Health Care.

These are rights under Federal and State Law:

1. You are not required to have an Advance Directive in order to receive medical treatment.

2. You have the right to accept or refuse medical treatment and to create an Advance Directive.

3. If you have an Advance Directive or decide to create one, Summit Endoscopy Center will honor it to the extent permitted by Georgia Law and in accordance with SEC policies and procedures. SEC physicians will not be able to follow your Advance Directive unless you provide a copy to the staff, verbalize your treatment preferences, or create a new document.

4. If your care provider cannot implement your Advance Directive on the basis of conscience she/he is obligated to transfer your care to a provider who will respect your wishes.

5. If you are a pregnant woman, your Advance Directive may not be honored once it is determined that the baby has developed enough to be able to survive if delivered.

6. Executing a Durable Power of Attorney for Healthcare will assure that your designate agent will have access to your medical record.

To request an official Georgia Advance Directive Form or for further questions call 770-461-2579. For additional information on Advance Directives and to print forms you may go to Please bring a copy of your Advance Directive, if you have completed one, to be scanned into your medical record.

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