United States Advance Directive Forms

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 an Advance Health Care Directive with this package of forms for Maryland residents.

• This package of forms contains:
  • information and instructions on how to understand, complete and execute your advance directive,
  • Selection of Health Care Agent ( a Durable Power of Attorney for Health Care) which lets you name an agent who will make health care decisions for you if you are unable to do so,
  • Treatment Preferences (a decisional directive or living will) which sets out your instructions regarding life-sustaining procedures and treatments,
  • Disposition of Body and Funeral Arrangements, where you can give instructions to your agent about organ and tissue donations after your death, and any instructions you have about funeral arrangements,
  • Signature and Witness section, with instructions to help you ensure that the signatures on your directive are legally valid.
• 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 easy-to-use forms are provided 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 Maryland.

Set out your wishes for life-sustaining treatment and appoint someone as your medical decision maker with this Advance Health Care Directive Forms Package for Michigan residents.

• None of us knows when an accident or illness might rob us of our ability to communicate. That's why we need to be prepared ahead of time.
• This package contains the following items:
  
  • Durable Power of Attorney for Health Care, where you can designate a patient advocate to make health care decisions for you if you become unable to do so,
  • Living Will, where you can give instructions regarding your preferences for life-prolonging treatments,
  • Do-Not-Resuscitate (DNR),
  • Declaration of Anatomical Gift (organ donor form),
  • instructions and information to help you understand and complete the documents.
• Available in MS Word format.
• These forms can be used by more than one member of your family.
• Intended to be used only by Michigan residents.

Set out your wishes for life-sustaining treatment and appoint someone as your medical decision maker with this Advance Health Care Directive Forms Package for Missouri residents.

• This package of forms contains the following:
  
  • information and instructions to help you prepare and complete your advance directive,
  • Advance Health Care Directive which is made up of:
    • Part I - Durable Power of Attorney for Health Care, where you can designate someone you trust to act as your agent to make health care decisions for you when you are unable to do so,
    • Part II - Health Care Directive, which allows you to state your wishes about health care treatments and procedures, including life-prolonging treatments,
    • Part III - General Provisions that are included in both documents,
    • Part IV - Execution.
• Making an Advance Directive can help to ensure that your family and your doctor know what your wishes if you should become unable to communicate or make your own decisions, and that there is someone with the authority to make decisions for you.
• The 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 Missouri.

Set out your instructions regarding life-sustaining procedures and end-of-life medical treatment with this Nevada Declaration form.

• The Declaration (also known as a "living will") gives you the opportunity to instruct your attending physician to withhold / withdraw life-sustaining treatment if you have a terminal condition which will likely cause your death in a short time.
• You can also choose to appoint someone else to make those decisions for you at the appropriate time.
• You can instruct your physician(s) to either administer or withhold / withdraw artificial hydration and nutrition.
• There is a separate section dealing with organ donation as well.
• The form includes information and instructions to help you complete it.
• Available in MS Word format.
• Intended to be used only in the State of Nevada.

Set out your wishes for end-of-life treatment and appoint someone as your health care representative with this Advance Directive for Health Care Package for New Jersey residents.

• This package of forms contains the following:
  • information and instructions to help you prepare and complete your advance directive,
  • Advance Health Care Directive which is made up of:
    • Part I - Proxy Directive (Durable Power of Attorney for Health Care), where you can designate someone you trust to act as your health care representative to make medical decisions for you when you are unable to do so,
    • Part II - Instruction Directive, where you can give directions to your doctor and your family about what types of life-prolonging treatments you want or do not want.
• Making an Advance Directive can help to ensure that your family and your doctor know what your wishes if you should become unable to communicate or make your own decisions, and that there is someone with the authority to make decisions for you.
• The 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 New Jersey.

Prepare for the unexpected with this New Mexico Advance Health Care Directive Forms Package.

• This forms package contains:
  • An overview of what an advance directive is, and what it means for you and your loved ones, and instructions to help you prepare and complete your advance directive.
  • Power of Attorney for Health Care, which lets you appoint an agent to make healthcare decisions for you if you become unable to do so.
  • Instructions for Healthcare, where you can set out your wishes and preferences for end-of-life treatments and procedures, as well as organ donation.
  • Designation of Primary Physician, where you can name one or more doctors that you want as your primary physician(s).
• Available in MS Word format, fully editable and easy to use.
• These forms can be used by every person in your family who wants to make an advance directive. No need to buy separate copies.
• Intended for use only in the State of New Mexico.

New York State residents can prepare an Advance Health Care Directive with the forms in this package.

• The package includes:
  • Advance Directive for Mental and Physical Health Care setting out your instructions regarding life support and life-sustaining treatments:
    • Health Care Proxy, appointing an agent to make health care decisions for you,
    • Statement of Desires and Instructions regarding Mental and Physical Health Care and Treatment (Living Will),
  • Information and instructions to help you complete the forms in accordance with the laws of the State of New York.
• Available in MS Word format.
• Intended to be used only in the State of New York.