Advance Directive: Living Will Form

Advance Directive: Durable Power of Attorney for Health Care Form

Print and fill out the above forms to complete your Pennsylvania Advance Directive

Advance medical directives are valuable tools that can help:

• you protect your right to make medical choices that affect your life
• your family avoid the responsibility - and stress - of making difficult decisions
• your physician by providing guidelines for your care.

Advance Medical Directives are used only when you are in a terminal condition or in a state of permanent unconsciousness.

There are two types of Advance Medical Directives:
1) A Living Will:
A document you fill out yourself, through which you can express your wishes regarding particular kinds of medical treatments that you may be offered when seriously ill. You can also name a health care surrogate to make medical decisions for you. This living will only applies if you are terminally ill or permanently unconscious.

2) Durable Power of Attorney for Health Care:
A legal document drawn up by an attorney that names a durable power of attorney for healthcare. This written health care power of attorney allows the person you name to make medical decisions for you in the event you are ever incapacitated, even though you are not terminally ill or permanently unconscious.

It is important to know that an advance directive is not the same thing as a “will”.

Filling out an advance directive form...

• You can get a form from your doctor’s office, home health agency, hospital, etc. Make sure your form is approved by your state due to the fact that forms vary from state to state
• Choose a “health care surrogate” who understands your values and wishes for treatment because he/she will be making your decisions for you if you can’t make them yourself. Be sure it is someone who will make the choices that you would make, even though they may not be the choices he/she would make in the same situation
• Don’t complete an advance directive form until you know exactly what you want it to say. Once those decisions are made, fill it out as quickly as possible so that it is available for whenever it is needed
• Give completed copies to your health care provider to be placed in your medical record file and to those closest to you so they can help carry out your wishes, if necessary keep a card in your wallet stating that you have advance directives and where to find them.

Is a lawyer necessary to complete an advance directive?
No, but you may want to see a lawyer if:

• You live in more than one state during the course of the year
• You don’t fully understand the standard advance directive form
• You find that the form does not allow you to express your actual health care preferences
• You have concerns that the advance directive form does not address

What if I need to change something on my advance directive form?

• You can go back to change something on your form long after it has been written. You should review the document on a regular basis to make sure it states your current health care wishes.
• Be sure to notify your doctors, caregivers and anyone else named on your advance directive form. Those who are responsible for carrying out your wishes need the most up-to-date copy.
• Your Advance Directive can be changed or canceled at any time.