To demonstrate my commitment to my freedoms and to compensate for the extra burden i am putting on the US. medical system.
I hereby decline medical treatment for COVlD-19-related medical conditions.
Witness Signature and Date Patient Signature and Date
Witness Printed Name Patient Printed Name


How about these cards:
I hereby decline medical treatment for alcohol-related medical conditions. I hereby decline medical treatment for obesity-related medical conditions. I hereby decline medical treatment for smoking-related medical conditions. I hereby decline medical treatment for recreational drug-related medical conditions. I hereby decline medical treatment for sexually transmitted disease-related medical conditions. I hereby decline medical treatment for motorcycle-injury related medical conditions. I hereby decline medical treatment for skydiving injury-related medical conditions. I hereby decline medical treatment for SCUBA diving injury-related medical conditions. etc., etc., etc.