Health Care Directive Template

Step by step instructions for completing this form click on blue instructions buttons for further directions.

Health care directive template. This is someone you trust to make health care decisions for you. Directives an advance directive can be used to name a health care agent. If you have attached any additional pages to this form you must date and sign each of the additional pages at the same time you date and sign this health care directive. Principal any person that has reached the age of 18 and has executed a written health care directive.

An advance health care directive is a document that instructs others about the medical care you wish to receive once you are no longer able to make or communicate your decisions. It also allows you to appoint an individual who will be in charge of communicating with your doctors and other health care providers on your behalf making sure that your health care choices are followed and respected. Health care agent a person or persons who are over the age of 18 years and appointed by the principal in a health care directive to make decisions regarding health care on the principals behalf. The statutory advance health care directive form is as follows.

An advance directive can also be used to say what your preferences are about treatments that might be used to sustain your life. A living will or instruction directive alerts medical professionals and your family to the treatments you want to receive or refuse. Minnesota health care directive medical poa living will which allows a person to appoint an agent to represent him or her with health decision making power andor allows the user to provide end of life care instructions can be used to either appoint someone medical poa provide instructions for care living will or bothas always there is the unfortunate possibility that you will be. The state offers a form to do this planning inclu ded with this pamphlet.

For health care any instructions i give in part 2 of this form and my other wishes to the extent known to my agent. A personal directive or health care directive or power of attorney for personal care allows someone the maker to give a person of their choice the authority to make decisions about their personal care should they become mentally incapable and to give directions to their health care providers about health care. The minnesota health care directive a planning toolkit use this pdf form to complete your personalized health care directive fill out on line and save your private document to make changes in the future. This health care directive will not be valid unless it is notarized or signed by two qualified witnesses who are present when you sign or acknowledge your signature.

Advance health care directive forms 4700 4701 chapter 2 added by stats. Decisions about personal care involve things such as where one lives what one.