ASK ‘PRINCIPALS’ After creating your FEPOA, did you do any of the following? Please select all that apply. MULTIPLE RESPONSE, RANDOMISE Registered it in your state or territory.....................................................................1 Kept the original FEPOA in a safe place................................................................2 Gave a copy to the appointed decision-maker(s)..............................................3 Gave a copy to your solicitor..................................................................................... 4 Gave a copy to a person other than the appointed decision-maker or your solicitor................................................................................5 Told someone you trusted that you had created a FEPOA............................6 None of the above...........................................................................................................7 Exclusive CONSIDERATIONS WHEN MAKING EPOA ARRANGEMENTS ASK ‘PRINCIPALS’ How many people have you appointed as decision-makers? OPEN COMMENT, NUMERICAL, ALLOW 1-200 Not sure / don’t remember...........................................................................................1 ASK ‘PRINCIPALS’ How many FEPOA agreements do you have? Note: Here we are interested in the number of separate agreements you have, not how many appointed decision-makers you have. OPEN COMMENT, NUMERICAL, ALLOW 1-200 Chapter : 9 Appendices 75

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