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The Kentucky Office of the Attorney General provides a PDF of an Advance Health Care Directive form in both English and Spanish on their website, linked below. Note that the terminology they use for a Healthcare Proxy is a "Health Care Surrogate". The form should be signed by two witnesses or notarized.

A Do Not Resuscitate (DNR) order is another kind of advance directive. A DNR is a request not to have cardiopulmonary resuscitation (CPR) if your heart stops or if you stop breathing. (Unless given other instructions, hospital staff will try to help all patients whose heart has stopped or who have stopped breathing.)

The most common types of advance directives are the living will and the durable power of attorney for health care (sometimes known as the medical power of attorney). There are many advance directive formats.

INTRODUCTION TO YOUR KENTUCKY ADVANCE HEALTH CARE DIRECTIVE This packet contains a Kentucky Living Will Directive (or ?Advance Directive?), which protects your right to refuse medical treatment you do not want or to request treatment you do want in the event you lose the ability to make decisions yourself.

The most common types of advance directives are the living will and the durable power of attorney for health care (sometimes known as the medical power of attorney).

This form lets you choose the kind of health care you want. This way, those who care for you will not have to guess what you want if you are not able to tell them yourself. The form must be signed before it can be used. This is a legal form that lets you have a voice in your health care.