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Incapacity Planning Checklist

*Name:
*Email:

   * These fields are optional, unless follow-up is requested. 
 
Would you like an Investaflex Representative to follow-up and discuss your answers with you?

Yes
No
1.  I have a power of attorney arranged for when I need one.
Yes
No
Unsure
2.  I have discussed my wishes with my family and/or advisor.
Yes
No
Unsure
Yes
No
Unsure
3.  I am confident that I will have the cash flow required to accommodate me if I need longterm care.
Yes
No
Unsure
4.  I have a living will and a health care representative letter.
Yes
No
Unsure
5.  I have an alternative power of attorney.
Yes
No
Unsure
6.  I am aware of the powers of the Public Trustee.
Yes
No
Unsure
7.  My spouse knows what to do (financial and health wise) if I am faced with incapacitation.
Yes
No
Unsure
8.  I am aware that the probability of incapacitation before death is much greater than the probability of death without prior incapacitation.
Yes
No
Unsure
9.  I am the main income-earner in my family.
Yes
No
Unsure
10.  I have decided who is the best person to look after my interests if I become incapacitated.

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Tel: 604.331.2520  |   Toll Free: 1.888.496.3539   |   info@investaflex.com

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