4. A terminally ill patient may make a written request for medication that the patient may choose to self-administer pursuant to P.L.2019, c.59 (C.26:16-1 et al.), if the patient:
a. is an adult resident of New Jersey as demonstrated pursuant to section 11 of P.L.2019, c.59 (C.26:16-11);
b. is capable and has been determined by the patient's attending physician and a consulting physician to be terminally ill; and
c. has voluntarily expressed a wish to receive a prescription for medication pursuant to P.L.2019, c.59 (C.26:16-1 et al.).