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505-393-1321

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    • About the End of Life Options Act
    • – Eligibility
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    • – Elizabeth Whitefield
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Menu
  • About Us
    • News & Updates
    • Our Staff & Board
      • Board Resources
      • Volunteer Resources
    • Advisors
    • Annual Reports
      • 2022 Financial Information
      • 2022 Annual Report
      • 2021 Annual Report
    • Our History
    • Vision, Mission, and Values
    • What We Do
    • Contact Us
  • Options
    • Intro to End of Life Options
    • Continue Treatments
    • Forgo or Cease Treatment
    • Palliative Care
    • Hospice
    • Palliative Sedation
    • VSED
    • Medical Aid in Dying (MAID)
  • EOLO Act
    • About the End of Life Options Act
    • – Eligibility
    • – Steps for Using the EOLO Act
    • – Elizabeth Whitefield
    • Aid in Dying Laws
    • For Individuals and Families
    • – FAQs for Families
    • For Providers
    • – Provider Training
    • – FAQs for Providers
  • Advance Care Planning
    • Advance Care Planning
    • – Advance Directives
    • – Healthcare Surrogates
    • – Dementia Directives
    • Medical Orders
    • – Medical Orders for Scope of Treatment (MOST)
    • – Do Not Resuscitate (DNR) Orders
  • Ways to Help
    • Contact Us
    • Volunteer
    • Donate
  • Events
    • Events – Month View
    • Events – List View
  • Volunteer Overview
  • Client Support Volunteer (CSV) Team
    • CSV Calendar
    • CSV Forms for Download
    • Online Story Form
  • Public Outreach Education (POE) Team
    • POE Calendar
    • Pre-Event Form
    • Sign-up Sheets
    • Online Story Form
    • Post-Activity Report
Menu
  • Volunteer Overview
  • Client Support Volunteer (CSV) Team
    • CSV Calendar
    • CSV Forms for Download
    • Online Story Form
  • Public Outreach Education (POE) Team
    • POE Calendar
    • Pre-Event Form
    • Sign-up Sheets
    • Online Story Form
    • Post-Activity Report

Client Support Volunteers

For updates to this page, contact Julia at ‭(505) 660-5194‬.

CSV Forms & Resources

  • MAID Dual Language Request Form
  • MAID Request Form
  • Medication Assistance Fund Request
  • Med. Assist. Fund Request - Spanish
MAID Request Dual Language
Last updated Nov. 2023

Medical Aid In Dying (MAID)
Dual Language Request form

In English and Spanish. 3 pages.

Download pdf
Request For Medication
Last updated Nov. 2023

Medication Assistance In Dying (MAID) Request Form

text to come

Download pdf
Med Assist Request
Last updated Nov. 2023

Medical Assistance Fund Request

text to come

Download pdf
EOLONM-fin-assist-spanish
Last updated Nov. 2023

Medical Assistance Fund Request in Spanish

Forumulario de Solicidad de Fondo de Medicamentos

Download pdf
EOLONM-logo-white

c/o Delta Management
500 Marquette Ave. NW
Suite 280
Albuquerque NM 87102

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  • 505-393-1321

About Us

  • Board
  • Advisors
  • Our History
  • Vision, Mission and Values
  • What We Do
  • Contact Us

End of Life Options

  • End of Life Options
  • Continue Treatment
  • Forgo Treatment
  • Palliative Care
  • Hospice
  • Palliative Sedation
  • VSED
  • Medical Aid in Dying
  • Facebook
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EOLO Act

  • EOLO Act
  • About the EOLO Act
  • - Eligibility
  • - Steps for Using the EOLO Act
  • - Elizabeth Whitefield
  • Aid in Dying Laws
  • For Individuals and Families
  • - FAQs for Families
  • For Providers
  • - Provider Training
  • - FAQs for Providers

Advance Care Planning

  • Advance Care Planning
  • Advance Directives
  • Healthcare Surrogates
  • Dementia Directives
  • Medical Orders
  • NM MOST
  • DNR Orders

Events

  • Events - Month View
  • Events - List View

Ways to Help

  • Contact Us
  • Volunteer
  • Donate

Recent Posts

Yes, Gold.

November 14, 2023

#GivingTuesday is Coming — Support EOLONM!

November 10, 2023

2023 Fall Newsletter

October 25, 2023

Update from the Chair

October 24, 2023

News from Julia

October 24, 2023

Community News

October 24, 2023

Newsletter

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