(1) Examine the individual and his or her relevant medical records;
(2) Confirm, in writing, to the attending physician:
(a) That the individual has a terminal illness;
(b) The individual has a prognosis of six months or less;
(c) That the individual is making an informed decision; and
(d) That the individual is mentally capable, or provide documentation that the consulting physician has referred the individual for further evaluation in accordance with section 25-48-108.