With this form, you can name someone to make medical decisions for you if in the future you're unable to make those decisions yourself. You can also say what medical treatments you want and what medical treatments you don't want if in the future you're unable to make your wishes known.
Instructions Read each section carefully.
Write your initials in the blank spaces before the choices you want to make. Add any special instructions in the blank spaces provided. You can write additional comments on a separate sheet of paper, but you should write on this form that there are additional pages to your advance directive. Sign the form and have it witnessed. Give copies to your doctor, your nurse, the person you name to make your medical decisions for you, people in your family and anyone else who might be involved in your care.