Uniform Healthcare Act Form

State:
Multi-State
Control #:
US-01613
Format:
Word; 
Rich Text
Instant download

Description

This form is a model example of an Advance Health Care Directive. It may not comply with the law of your state on health care directives, medical power of attorney and/or living wills - and must be adapted to the law of your state.
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  • Preview Uniform Healthcare Act Form
  • Preview Uniform Healthcare Act Form
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FAQ

Health care decision means a decision made by a patient or the patient's agent, conservator, or surrogate, regarding the patient's health care, including the following: 27a2 Selection and discharge of health care providers and institutions, 27a2 Approval or disapproval of diagnostic tests, surgical procedures, and programs

Get the living will and medical power of attorney forms for your state, or use a universal form that has been approved by many states. Choose your health care agent. Fill out the forms, and have them witnessed as your state requires.

You can usually get advance directive forms from your state bar association, or from Caring Connection (part of the National Hospice and Palliative Care Organization). Additionally, when you are ready to fill out your advance directive, your health care team might be able to help.

Sign Your California Advance Directive in Front of Two Witnesses or a Notary Public. After you create your advance directive, you must sign your document and have it either signed by two witnesses or notarized. If you choose to have the document witnessed, neither of your witnesses may be: your health care agent.

Uniform Health-Care Decisions Act (UHCDA) is a uniform act drafted by the National Conference of Commissioners on Uniform State Laws in 1993.UHCDA also provides a form for executing a health-care power of attorney, for written instructions to a health-care provider, and even for making anatomical gifts.

Both the Uniform Health-Care Decisions Act (UHCDA) and the Uniform Guardianship and Protective Proceedings Act (UGPPA) advocate the inclusion of a decision-making standard that generally follows a three-step hierarchy in decision-making: (1) in accordance with the explicit instructions of the individual, (2) in

Review and complete the Advance Health Care Planning: Making Your Wishes Known Booklet. Complete An Advance Health Care Directive Form. Give a copy to your doctor, power of attorney and family. If necessary, complete a Provider Orders for Life Sustaining Treatment (POLST) Form.

The name and contact information of your healthcare agent/proxy. Answers to specific questions about your preferences for care if you become unable to speak for yourself. Names and signatures of individuals who witness your signing your advance directive, if required.

"Conservator" means a court-appointed conservator having authority to make a health care decision for a patient. 4615.

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Uniform Healthcare Act Form