If you use this form you may complete or modify all or any part of it. You are free to use a different form. Part 1 of this form is a power of attorney for
You are free to use a different form. Part 1 of this form is a power of attorney for health care. Part 1 lets you name another individual as agent to make
GENERAL INSTRUCTIONS: You can use this Advance Directive ("Living Will") form to give instructions for the free of pain as possible so that my dignity is ...
ADVANCE DIRECTIVE FOR HEALTH CARE. (Living Will and Health Care Proxy). This form may be used in the State of Alabama to make your wishes known about what
I do not give such permission (this form applies only when I no longer have capacity). Part 2 Indicate Your Wishes for Quality of Life: By marking “yes” below
Register your Advance. Directive free of charge in Hawaii's own Document Bank at www .myhealthdirective.com. ____. Place copies in your medical files. ____.
In Section B and C you may state the circumstances in which various forms of medical treatment
This newly created form using understandable and everyday language is meant to encourage more citizens of Georgia to voluntarily execute advance directives for
WHY DOES THE ARIZONA ATTORNEY GENERAL OFFER THESE FORMS? The Arizona Attorney General's Office wants to make sure that all Arizonans have access to these free
Where can I find advance directive forms? Florida law provides a sample of each of the following forms: a living will a health care surrogate
If you use this form you may complete or modify all or any part of it. You are free to use a different form. Part 1 of this form is a power of attorney for
I wish medical treatment to be limited to keeping me comfortable and free from pain and I refuse all other medical treatment. Permanent Mental Impairment: If
I do not give such permission (this form applies only when I no longer have capacity). Part 2 Indicate Your Wishes for Quality of Life: By marking “yes” below
Advance Directives are your written wishes about what you want to happen if you get too sick to be able to say. Living Will or Advance Care Plan. Machines and
us to supplying one set of forms to each requester. But please feel free to make as many copies as you wish. Additional information about advance directives
Maine Health Care Advance Directive Form. You may use this form now to tell your physician and others what medical care you want to receive.
Maine Health Care. Advance Directive Form. You may use this form now to tell your physician and others what medical care you want to receive if you.
providers pursuant to the Oklahoma Advance Directive Act
GENERAL INSTRUCTIONS: You can use this Advance Directive ("Living Will") form to give instructions for the future if you want your health care providers to
This form lets you choose the kind of health care you want. Pennsylvania Advance Health Care Directive ... Be free from pain.