Advanced Health Care Directive Template

Your advance medical directive medical power of attorney and living will need to be notarized in some states depending on who witnesses your signature in order to be legally valid.

Advanced health care directive template. Advance health care directive form. In our example we are using the living will as seen below. Notify your healthcare provider. If you wish to only use the medical power of attorney strike an x through this section.

Page 1 of 6. Uniform health care decisions act 4670 4743 part 2 added by stats. To name a health care agent use part i of the advance directive form. Directive and revoke all previous advance health care directives powers of attorney for health care living wills and similar documents made by me.

This document combines a health care directive which is your living will along with a medical power of attorney to appoint an agent. In some states the living will and health care proxy forms are combined into a single document. Selection of health care agent you can name anyone you want except in general someone who works for a health care facility where you are receiving care to be your health care agent. Advance care planning and the law.

There is however a growing movement towards the creation of a universal advance directive which would work in all states. If illness or serious injury temporary or permanent prevents you from making decisions about your health care advance care planning makes sure that your values beliefs and preferences for treatment and care are understood and respected. Advance directives advance directives formerly known as living wills are documents you create while you are feeling well and thinking clearly that explain to your family and your health care providers the extent of medical treatment you wish to receiveor not receiveshould you become unconscious or too ill to make the decision at a later point in your life. Probate code prob division 47.

Step 2 health care directive. A living will or instruction directive alerts medical professionals and your family to the treatments you want to receive or refuse. To make medical decisions you must have decision making capacity. Power of attorney for health care optionalif you do not wish to appoint someone to make health care decisions for.

Step 3 life support. A medical power of attorney allows you to appoint a person to make healthcare decisions on your behalfif. In other states the forms are separate. Part i of the advance directive.

Provide your healthcare proxy or agent primary care physician hospital. Every state has its own advance directive forms.