Agreement and Guidelines for a Safe and Peaceful MAID Process

$1,000.00

Thank you for contacting our team for assistance. It is a privilege to support you through the process. This agreement provides important information to you as a non-resident of Vermont, to ensure a smooth, peaceful process navigating Vermont’s laws and regulations pertaining to Medical Aid In Dying (MAID), commonly referred to as Act 39. This agreement outlines how we can help you and what we need from you to provide effective support. 

The Comfort Project team acknowledges that you are pursuing this process of your own free will. Our team members are not responsible for your decision and will not attempt to influence your decision or actions related to MAID.

What We Offer

The essence of our support is to provide non-medical care for Medical Aid in Dying. We guide you through the steps from initial planning to being present on the day the medication is ingested.

  • We clarify complex information about MAID eligibility requirements, as well as what is needed to successfully complete the process.          

  • We help you coordinate with your medical team in Vermont and the pharmacist.       

  • We assist in identifying appropriate local lodging where you can ingest the medication.

  • We provide information to help you coordinate post-mortem arrangements. 

  • We provide a trusted courier to pick up the medication from the pharmacist in Rutland, VT and deliver it to the location of your ingestion. 

  • We meet with you and your family/friends the day before the ingestion to review the standard Vermont Medication Instructions and together we create a plan for ingestion day.

  • We keep the medical team (doctors and hospice) informed of logistical plans related to your ingestion. 

  • On the day of ingestion, two members of our team are present: we provide compassionate, practical care. At the family’s request, we mix the medication and monitor ingestion. 

  • After the death, we notify hospice and the funeral home, which initiates the death certificate process and post-mortem care.

  • We remain present with family/friends until the ingestion and post-ingestion process is complete.  

  • We provide resources about free grief support groups for your survivors.                                                                                                                                            

What We Need From You
A peaceful and smooth MAID experience depends on thoughtful preparation and collaboration. By signing this agreement, you acknowledge that you and your caregivers will be responsible for completing the necessary tasks described below. 

  • Provide us with your complete contact information including name, phone number, email address and physical address. 

  • Designate at least one caregiver who will be present at the ingestion, and provide their contact information including name, phone number, email address and physical address. 

  • Provide us with the schedule of your MAID medical appointments, including informing us of any changes to appointment dates/times.

  • Keep us informed of your desired ingestion date and notify us of any changes as soon as possible. We need at least two weeks notice so we can help you plan and coordinate the necessary arrangements. (Scheduling your desired ingestion date is not entirely under our control). 

  • Communicate any changes in your condition or situation that may impact your MAID plans.

  • Follow the guidance in the standard Vermont Medication Instructions regarding the protocol for ingestion day.

What We Do Not Offer

  • The Comfort Project does not assume custodial, medical, guardianship, or long-term care responsibility for the Client during or beyond the terms of this Agreement.

Authorization for Disclosure of Information
With this agreement, you authorize your care provider from the non-medical support team of The Comfort Project to exchange information on your behalf with the following healthcare providers and professionals: 

  • The physicians and staff at Grace Cottage Hospital in Townsend, Vermont or any physicians you work with for pursuing Medical Aid in Dying in Vermont. 

  • Bayada Hospice in Brattleboro, Vermont

  • The designated compounding pharmacist in Vermont

  • Members of The Comfort Project team

Scope of Information Disclosure
The information authorized for disclosure is strictly limited to logistical support matters and medical information as it pertains to Medical Aid in Dying and does not grant access to retrieve or request medical records.

Right to Revoke Authorization
You have the right to rescind or revoke this authorization at any time by providing written notice to The Comfort Project. Revocation will not affect any disclosures already made with your consent prior to receiving your written notice.

Waiver of Liability
You, your heirs, successors and assigns agree to waive any and all rights, claims or causes of action that you may have against The Comfort Project, and their team members who assist you. You understand that team members of The Comfort Project  are not medical professionals, and therefore, do not provide you with medical advice or medical treatment.

You understand and agree that this Waiver of Liability is a COMPLETE RELEASE AND DISCHARGE of all liability whatsoever.

Services Offered and Payment Structure
Below we describe the concrete services that we offer, yet equally important to us are the less tangible ways that we offer emotional guidance and support for the people who are involved in this extraordinary choice. This process has a profound effect on everyone involved and the comfort we provide is an important part of our work together.  

Payment ($1,000 total)
Payment Requirements: Due when you submit this Agreement.  

Services Included:
You, as a client, or friend, family member will be given access to the Client Portal, a comprehensive compilation of helpful resources we’ve accumulated over the years. 

  • Coordination with your doctors, hospice providers, and pharmacists in Vermont 

  • Meetings with you and your family or support team (via phone or Zoom) to develop a plan based on your needs, your timeframe, and those of our service providers in Vermont

  • Coordination of travel and accommodations

  • We keep the medical team (doctors and hospice) informed of logistical plans related to your ingestion. 

  • Together we identify an appropriate and safe location for ingestion.

  • We meet with you and your family/friends the day before ingestion to review the standard Vermont Medication Instructions; together we create a plan for ingestion day.

  • We pick up the medication from the pharmacist in Vermont and deliver it to the location of your ingestion. 

  • On the day of ingestion, two members of our team are present: we provide compassionate, practical care; at the family’s request, we mix the medication and monitor ingestion; after death we notify hospice and the funeral home, which initiates the death certificate process.   

  • Coordination with hospice and funeral home for post-mortem care.

  • We remain present with family/friends until the ingestion and post-ingestion process is complete.  

  • We provide resources about free grief support groups.  

Duration of Our Services

The above referenced list of “What We Offer” is comprised of two distinct phases: 

Phase 1: While you are at home, not in the state of Vermont. 

In this phase, our services are available for eight (8) weeks. Upon the completion of eight weeks, this contract expires and a new contract will need to be signed and paid for. 

Phase 2: While you are in Vermont. 

This phase begins upon the client’s arrival in Vermont or the initiation of in-state coordination services, whichever occurs first. In this phase, our services are available for three (3) days. Upon the completion of three (3) days after arrival in Vermont, this contract expires and a new contract will need to be signed and paid for. 

Additional Time in Vermont Beyond the Duration of our Services

If the client remains in Vermont beyond the initial three (3) day service period, The Comfort Project does not assume any responsibility for the client’s care. Any additional transitional or logistical services requested of The Comfort Project may be provided at a rate of $500 per day, are subject to availability and must be agreed to with an additional Agreement. 

Term and Termination of Agreement

The term of this Agreement shall commence on the date that we receive your initial payment and shall terminate upon the earliest of the following:

  • Completion of services on ingestion day;

  • Eight weeks from the date this agreement is signed

  • Expiration of the three (3) days in-Vermont (Phase 2);

  • Termination by The Comfort Project due to lack of a designated responsible support person, or circumstances outside the scope of this agreement.

  • Any of the following “Triggering Events”, understood as the following: 

Triggering Event A: Change of Mind to pursue Medical Aid in Dying.
We recognize that choosing MAID is a profound and personal decision, and a client always retains the right to change their mind.

Triggering Event B: Natural Death prior to a planned death by Medical Aid.
Given the unpredictable nature and timing of death, we recognize that, while you are pursuing MAID, a natural death is possible. 

Triggering Event C: Ineligibility for MAID, as determined by medical professionals.
We recognize that eligibility for MAID is not guaranteed and that medical or legal variables may shift unexpectedly.  This is extremely rare. 

Any other Triggering Events that are not described in this Agreement.
Upon termination of the Agreement, by either party, The Comfort Project’s obligations shall cease except for minimal, reasonable administrative wrap-up and minimal, reasonable coordination already underway.

Reimbursement:
The Comfort Project’s fee reflects the significant administrative coordination, professional time, and logistical preparation required to support each client’s Medical Aid in Dying process. The majority of this work occurs prior to a client’s arrival in Vermont and cannot be reassigned once initiated. For this reason, fees are non-refundable once coordination has begun.

Acknowledgements:
By signing this agreement, you acknowledge that The Comfort Project provides non-medical, supportive services and that all decisions regarding Medical Aid in Dying are made by you and your licensed healthcare providers. You are agreeing to allow The Comfort Project to perform our services on the terms and conditions provided in this Agreement. You agree to the Waiver of Liability stated above related to your decision to pursue Medical Aid in Dying. This agreement is entered into voluntarily and with full understanding of its contents.

Thank you for contacting our team for assistance. It is a privilege to support you through the process. This agreement provides important information to you as a non-resident of Vermont, to ensure a smooth, peaceful process navigating Vermont’s laws and regulations pertaining to Medical Aid In Dying (MAID), commonly referred to as Act 39. This agreement outlines how we can help you and what we need from you to provide effective support. 

The Comfort Project team acknowledges that you are pursuing this process of your own free will. Our team members are not responsible for your decision and will not attempt to influence your decision or actions related to MAID.

What We Offer

The essence of our support is to provide non-medical care for Medical Aid in Dying. We guide you through the steps from initial planning to being present on the day the medication is ingested.

  • We clarify complex information about MAID eligibility requirements, as well as what is needed to successfully complete the process.          

  • We help you coordinate with your medical team in Vermont and the pharmacist.       

  • We assist in identifying appropriate local lodging where you can ingest the medication.

  • We provide information to help you coordinate post-mortem arrangements. 

  • We provide a trusted courier to pick up the medication from the pharmacist in Rutland, VT and deliver it to the location of your ingestion. 

  • We meet with you and your family/friends the day before the ingestion to review the standard Vermont Medication Instructions and together we create a plan for ingestion day.

  • We keep the medical team (doctors and hospice) informed of logistical plans related to your ingestion. 

  • On the day of ingestion, two members of our team are present: we provide compassionate, practical care. At the family’s request, we mix the medication and monitor ingestion. 

  • After the death, we notify hospice and the funeral home, which initiates the death certificate process and post-mortem care.

  • We remain present with family/friends until the ingestion and post-ingestion process is complete.  

  • We provide resources about free grief support groups for your survivors.                                                                                                                                            

What We Need From You
A peaceful and smooth MAID experience depends on thoughtful preparation and collaboration. By signing this agreement, you acknowledge that you and your caregivers will be responsible for completing the necessary tasks described below. 

  • Provide us with your complete contact information including name, phone number, email address and physical address. 

  • Designate at least one caregiver who will be present at the ingestion, and provide their contact information including name, phone number, email address and physical address. 

  • Provide us with the schedule of your MAID medical appointments, including informing us of any changes to appointment dates/times.

  • Keep us informed of your desired ingestion date and notify us of any changes as soon as possible. We need at least two weeks notice so we can help you plan and coordinate the necessary arrangements. (Scheduling your desired ingestion date is not entirely under our control). 

  • Communicate any changes in your condition or situation that may impact your MAID plans.

  • Follow the guidance in the standard Vermont Medication Instructions regarding the protocol for ingestion day.

What We Do Not Offer

  • The Comfort Project does not assume custodial, medical, guardianship, or long-term care responsibility for the Client during or beyond the terms of this Agreement.

Authorization for Disclosure of Information
With this agreement, you authorize your care provider from the non-medical support team of The Comfort Project to exchange information on your behalf with the following healthcare providers and professionals: 

  • The physicians and staff at Grace Cottage Hospital in Townsend, Vermont or any physicians you work with for pursuing Medical Aid in Dying in Vermont. 

  • Bayada Hospice in Brattleboro, Vermont

  • The designated compounding pharmacist in Vermont

  • Members of The Comfort Project team

Scope of Information Disclosure
The information authorized for disclosure is strictly limited to logistical support matters and medical information as it pertains to Medical Aid in Dying and does not grant access to retrieve or request medical records.

Right to Revoke Authorization
You have the right to rescind or revoke this authorization at any time by providing written notice to The Comfort Project. Revocation will not affect any disclosures already made with your consent prior to receiving your written notice.

Waiver of Liability
You, your heirs, successors and assigns agree to waive any and all rights, claims or causes of action that you may have against The Comfort Project, and their team members who assist you. You understand that team members of The Comfort Project  are not medical professionals, and therefore, do not provide you with medical advice or medical treatment.

You understand and agree that this Waiver of Liability is a COMPLETE RELEASE AND DISCHARGE of all liability whatsoever.

Services Offered and Payment Structure
Below we describe the concrete services that we offer, yet equally important to us are the less tangible ways that we offer emotional guidance and support for the people who are involved in this extraordinary choice. This process has a profound effect on everyone involved and the comfort we provide is an important part of our work together.  

Payment ($1,000 total)
Payment Requirements: Due when you submit this Agreement.  

Services Included:
You, as a client, or friend, family member will be given access to the Client Portal, a comprehensive compilation of helpful resources we’ve accumulated over the years. 

  • Coordination with your doctors, hospice providers, and pharmacists in Vermont 

  • Meetings with you and your family or support team (via phone or Zoom) to develop a plan based on your needs, your timeframe, and those of our service providers in Vermont

  • Coordination of travel and accommodations

  • We keep the medical team (doctors and hospice) informed of logistical plans related to your ingestion. 

  • Together we identify an appropriate and safe location for ingestion.

  • We meet with you and your family/friends the day before ingestion to review the standard Vermont Medication Instructions; together we create a plan for ingestion day.

  • We pick up the medication from the pharmacist in Vermont and deliver it to the location of your ingestion. 

  • On the day of ingestion, two members of our team are present: we provide compassionate, practical care; at the family’s request, we mix the medication and monitor ingestion; after death we notify hospice and the funeral home, which initiates the death certificate process.   

  • Coordination with hospice and funeral home for post-mortem care.

  • We remain present with family/friends until the ingestion and post-ingestion process is complete.  

  • We provide resources about free grief support groups.  

Duration of Our Services

The above referenced list of “What We Offer” is comprised of two distinct phases: 

Phase 1: While you are at home, not in the state of Vermont. 

In this phase, our services are available for eight (8) weeks. Upon the completion of eight weeks, this contract expires and a new contract will need to be signed and paid for. 

Phase 2: While you are in Vermont. 

This phase begins upon the client’s arrival in Vermont or the initiation of in-state coordination services, whichever occurs first. In this phase, our services are available for three (3) days. Upon the completion of three (3) days after arrival in Vermont, this contract expires and a new contract will need to be signed and paid for. 

Additional Time in Vermont Beyond the Duration of our Services

If the client remains in Vermont beyond the initial three (3) day service period, The Comfort Project does not assume any responsibility for the client’s care. Any additional transitional or logistical services requested of The Comfort Project may be provided at a rate of $500 per day, are subject to availability and must be agreed to with an additional Agreement. 

Term and Termination of Agreement

The term of this Agreement shall commence on the date that we receive your initial payment and shall terminate upon the earliest of the following:

  • Completion of services on ingestion day;

  • Eight weeks from the date this agreement is signed

  • Expiration of the three (3) days in-Vermont (Phase 2);

  • Termination by The Comfort Project due to lack of a designated responsible support person, or circumstances outside the scope of this agreement.

  • Any of the following “Triggering Events”, understood as the following: 

Triggering Event A: Change of Mind to pursue Medical Aid in Dying.
We recognize that choosing MAID is a profound and personal decision, and a client always retains the right to change their mind.

Triggering Event B: Natural Death prior to a planned death by Medical Aid.
Given the unpredictable nature and timing of death, we recognize that, while you are pursuing MAID, a natural death is possible. 

Triggering Event C: Ineligibility for MAID, as determined by medical professionals.
We recognize that eligibility for MAID is not guaranteed and that medical or legal variables may shift unexpectedly.  This is extremely rare. 

Any other Triggering Events that are not described in this Agreement.
Upon termination of the Agreement, by either party, The Comfort Project’s obligations shall cease except for minimal, reasonable administrative wrap-up and minimal, reasonable coordination already underway.

Reimbursement:
The Comfort Project’s fee reflects the significant administrative coordination, professional time, and logistical preparation required to support each client’s Medical Aid in Dying process. The majority of this work occurs prior to a client’s arrival in Vermont and cannot be reassigned once initiated. For this reason, fees are non-refundable once coordination has begun.

Acknowledgements:
By signing this agreement, you acknowledge that The Comfort Project provides non-medical, supportive services and that all decisions regarding Medical Aid in Dying are made by you and your licensed healthcare providers. You are agreeing to allow The Comfort Project to perform our services on the terms and conditions provided in this Agreement. You agree to the Waiver of Liability stated above related to your decision to pursue Medical Aid in Dying. This agreement is entered into voluntarily and with full understanding of its contents.