Summary

Use this form if you need someone to fill in and sign an advance care dierective for you, at your direction. This document allows an adult to document their preferences for future medical treatment, should they lose decision-making capacity. A person can record general statements about their values and preferences to guide future medical treatment decisions, or record instructions consenting to or refusing specific types of treatment.

Details

Publication Type
Document
Topic
Forms and templates
Date Published
07 Mar 2018
Size
7 pages
Available format
PDF
Author
Department of Health & Human Services