How to Fill Out an Advance Directive

An advance directive consists of two separate legal documents regarding end-of-life requests. These documents go into effect in the event that you develop a condition that prevents you from making medical decisions for yourself. The first part of the advance directive is a living will, which states medical treatments that you do wish and do not wish to receive from a health care provider. The second part is a health care proxy, which appoints a health care surrogate who can make medical decisions for you should you become incapacitated.

Difficulty: Moderate

Instructions

1. Print out the advance directive and instructions for your state (see Resources). The requirements on the form vary from state to state and will not be valid in your state unless you have used the appropriate directive.

2. Fill out your living will according to the instructions on the form. Insert your name into the beginning of the living will and select the treatments that you do not wish to receive, such as cardiac resuscitation or mechanical respiration. Add any personal instructions on the second page, and then sign and date the form in the presence of two witnesses.

3. Have your living will signed by two separate witnesses. They will also need to print their addresses on the form for identification purposes.

4. Complete the health care proxy. Make sure that you inform the person that you will be appointing him as your health care proxy and explain all of your wishes to him. You can choose a family member or friend as your proxy and appoint an alternate in case the first person cannot fulfill the duties. Choose to donate your organs if you would like, and then sign and date the form in the presence of two witnesses.

5. Get the health care proxy signed by two witnesses and have them print their addresses on the form. These signatures will validate the health care proxy.

Tips & Warnings

• An advance directive will not go into effect until two separate physicians have certified that you are unable to make your own medical decisions.
• There are a few limitations regarding who can be appointed as your health care proxy. The person cannot be an employee of a health care facility, your attending physician or anyone who is already assigned as a proxy to 10 or more other people, unless the person is related to you.
• The person you name as your health care proxy may not serve as one of the witnesses. Make sure you get two additional signatures other than that of your proxy.
• While you do not need a lawyer to fill out an advance directive, you should have someone close to you double-check the forms to make sure all of the parts are filled out correctly.

References

• Caring Info

Resources

• State-Specific Advance Directives

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