Advance Medical Directive Forms

Make sure your family and your doctor know what your wishes are regarding medical treatment and life support with this free Advance Health Care Directive Form for California.

• An Advance Health Care Directive speaks for you if you are unable to communicate due to illness or injury.
• In Part 1 of the form you can, but are not required to, name another person to act as your agent, to make health care decisions on your behalf if you become unable to do so, or even if you retain capacity.
• You can give instructions about your health care in Part 2, for your agent (if you appoint one) and for your health care provider to follow.
• The form includes information and instructions to help you complete it.
• This is Form 3-1 issued by the California Hospital Association.
• Available in PDF format.

Make an Advance Medical Directive with this package of forms for residents of Colorado.

• This package of forms contains the following:
  • information about the purpose and intent of an advance directive (also known as a Living Will or health care proxy),
  • instructions to help you complete the forms,
  • Advance Directive for Medical / Surgical Treatment setting out your instructions regarding life sustaining procedures.
  • Medical Durable Power of Attorney appointing an agent to make health care decisions for you.
• Making an Advance Directive can help to ensure that your family and your doctor know what your wishes are regarding medical treatment and life support if you are unable to communicate or make your own decisions.
• This package of forms is available in MS Word format and can be used by more than one person in your household.
• Intended to be used only in the State of Colorado.

Make your wishes for medical treatment known to your doctor and family with this Advance Health Care Directive forms package for Delaware.

• This package contains the following documents:
  • a Power of Attorney for Health Care that allows you to name someone you trust to act as your agent to make healthcare decisions for you if you become unable to do so,
  • a Health Care Directive (also known as a Living Will), in which you can give instructions about what types of end-of-life medical treatments you want or do not want,
  • an Anatomical Gift Declaration (organ donor form),
  • instructions and explanations to help you complete the forms.
• The forms can be used by more than one person in your family, just by filling in the appropriate information for each person.
• Available in MS Word format.
• Intended to be used only in the State of Delaware.

Name someone you trust to make medical decisions for you if you are unable to with this Advance Health Care Directive Package for District of Columbia residents.

• This package contains:
  • a Declaration (Living Will) setting out your wishes regarding end-of-life procedures and treatments,
  • a Durable Health Care Power of Attorney appointing an agent to make health care decisions for you,
  • an Organ Donation Form,
  • an explanation of each of the forms and answers to common questions such as how to ensure the documents are properly signed and witnessed,
  • instructions on how to prepare and complete each document.
• Available in MS Word format, fully editable and reusable.
• Intended to be used only in the District of Columbia.

Make certain that your wishes regarding medical treatment are known by your doctor and your family with this Advance Healthcare Directive package of forms for Florida residents.

• This package of forms contains the following documents:
  • a Living Will Declaration which sets out your instructions regarding life-sustaining procedures and other future health care decisions,
  • information and instructions to help you prepare and complete your advance directive forms,
  • a Designation of Health Care Surrogate appointing an agent to make health care decisions for you,
  • a Designation of Health Care Surrogate for Minor, which can be used to appoint an agent to make health care decisions for a person that is underage,
  • a Uniform Donor Form for organ and tissue donations.
• These easy-to-use forms are provided in MS Word format and can be used by more than one person by filling in the appropriate information.
• Intended to be used only in the State of Florida.

Appoint an agent and set out your wishes for medical treatment with this Georgia Advance Directive for Health Care Package.

• The Advance Directive for Health Care replaces both the previous Living Will declaration and the Durable Power of Attorney for Health Care.
• The Advance Directive gives you the opportunity to:
  • appoint a health care agent to make decisions about medical treatment and procedures for you,
  • set out your wishes and preferences for end-of-life treatment if you have a terminal condition or are in a state of permanent unconsciousness, and
  • name a person to act as your guardian, if a court should determine that a guardian is necessary.
• Making an Advance Directive can help to ensure that your family and your doctor know what your wishes are regarding medical treatment and life support if you are unable to communicate or make your own decisions.
• The package includes information and instructions to walk you through the process.
• Available in MS Word format. Easy to use and reusable, so more than one person can use the Advance Directive form by filling in the appropriate information.
• Intended to be used only in the State of Georgia.

Ensure your wishes for medical care are followed with this Advance Health Care Directive package for Illinois.

• This package of forms for Illinois contains:
  • Living Will Declaration, where you can set out your wishes for life-prolonging treatments and medications,
  • Declaration for Mental Health Treatment,
  • Statutory Short Form Power of Attorney for Health Care, where you can appoint someone you trust as your agent to make health care decisions for you, and
  • instructions and information to assist you in preparing and completing your advance directive.
• Making an Advance Directive can help to ensure that your family and your doctor know what your wishes are regarding medical treatment and life support if you are unable to communicate or make your own decisions.
• These forms are available in MS Word format and can be re-used by spouses, partners, and other family members.
• Intended to be used only in the State of Illinois.

Prepare a Living Will and make your wishes known regarding life-prolonging treatments with this Kentucky Advance Healthcare Directive package.

• This package of forms contains:
  • an explanation of what a Living Will is,
  • instructions to help you properly prepare and complete the form, and
  • Kentucky Living Will Directive and Health Care Surrogate Designation.
• Part I of the form is the Designation of Health Care Surrogate, where you can designate a person you trust as your agent to make healthcare decisions for you if you are unable to do so.
• Part II is the section in which you can set out your wishes and instructions regarding life-prolonging treatments, artificially provided nutrition and hydration, and organ and tissue donation.
• Making an advance directive ensures that your family and your doctor know what your wishes are regarding medical treatment and life support if you are unable to communicate or make your own decisions. 
• This easy-to-use package is provided in MS Word format and can be used by more than one person. Download as many copies as you need.
• Intended to be used only in the Commonwealth of Kentucky.

• an explanation of what an advance directive is,
• instructions on preparing and completing an advance directive,
• a Living Will Declaration which sets out your instructions regarding life-sustaining procedures and other future health care decisions,
• a Power of Attorney for Health Care Decisions appointing an agent to make health care decisions for you.

Make a Health Care Directive with this downloadable easy-to-use form for Manitoba residents.

• A Health Care Directive (also called a living will or advance directive) ensures that your wishes for medical treatment are followed in the event that you become unable to communicate those wishes due to illness or injury.
• You can appoint someone you trust to act on your behalf as your proxy, and give that person detailed instructions as to what types of medical treatment you want or don't want.
• The Health Care Directive form includes:
  • information and instructions to help you complete the form,
  • a Declaration of Incapacity form to be signed by two medical doctors.
• This is a downloadable MS Word file, which is easy to fill in and print.
• This Health Care Directive form was prepared in accordance with the Manitoba Health Care Directives Act.