Get 965 003e Advance Directive

Creating an advance directive is an important step in ensuring that your healthcare wishes are respected when you are unable to communicate them yourself. The 965 003e Advance Directive allows you to outline your medical decisions and appoint a health care proxy to ensure your choices are carried out.

Follow the steps to complete your advance directive online.

1. Press the ‘Get Form’ button to access the advance directive form and open it in your chosen editor.
2. Read the introduction carefully. This section outlines the purpose of the document, which is to provide instructions on your health care preferences if you become unable to make decisions.
3. In the first section regarding terminal conditions, you will need to initial one of the options provided to specify your wishes concerning life-sustaining treatment.
4. The next section addresses situations of persistent unconsciousness. Again, initial your chosen option that reflects your wishes regarding medical treatment.
5. Continue to the section that details end-stage conditions. As with the previous sections, review the options and initial one that represents your preferences.
6. If there are specific circumstances or conditions that were not covered, use paragraph (4) to provide additional details. Write your instructions clearly in the space provided.
7. In the section for appointing a health care proxy, enter the name of the individual you wish to designate as your proxy, and if desired, provide an alternate proxy.
8. If you wish to make anatomical gifts, initial all applicable options in the anatomical gifts section. Write down specific organs or body parts if necessary.
9. Review the general provisions section to ensure you understand the requirements for executing the document, including age and witness criteria.
10. Finally, sign and date the advance directive in the designated areas, and have your witnesses sign as well.
11. Once you have completed the form, save your changes, and ensure you have a copy for your records. You may also wish to share or print the form for your healthcare providers.

Ensure your healthcare wishes are known—fill out your advance directive online today.