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Free healthcare power of attorney form for all 50 states. Name a medical decision-maker and set care preferences. Includes living will directives. PDF download.
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An advance directive is a legal document that allows you to spell out your decisions about end-of-life care ahead of time (MedlinePlus/NIH). There are two main components: a living will, which tells which treatments you want if you are dying or permanently unconscious, and a healthcare proxy (also called a healthcare power of attorney or durable power of attorney for health care), which names someone to make medical decisions if you cannot speak for yourself. This form covers the healthcare-proxy portion with end-of-life care preferences included.
Primary healthcare agent and two successor designations, mental health treatment authorization, end-of-life care instructions, organ donation preferences, and state-specific signing requirement fields.
You choose. Most people have it take effect only when their physician determines they lack capacity. Alternatively, it can take effect immediately upon signing.
Someone you trust to make medical decisions that align with your values. Your agent should be an adult, willing to serve, and able to advocate for you with healthcare providers.
"Advance directive" is the umbrella term for legal documents that spell out your decisions about end-of-life care ahead of time (MedlinePlus). A living will tells which treatments you want if you are dying or permanently unconscious — things like resuscitation, breathing machines, or tube feeding. A healthcare proxy (also called a durable power of attorney for health care) names someone to make medical decisions for you if you cannot make or communicate them yourself. A complete advance directive typically includes both. This form combines the healthcare proxy with end-of-life care preferences, and some states formalize them as one document.
A medical power of attorney (also called a healthcare power of attorney, healthcare proxy, or durable power of attorney for health care) is one part of an advance directive — the part that names someone to make medical decisions on your behalf if you cannot. A complete advance directive pairs that with a living will, which specifies treatment preferences directly. Terminology varies by state: some states label the combined document a "medical power of attorney," others use "healthcare proxy" or "advance directive" as the parent label.
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