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What to Include in Your Advance Directive. The name and contact information of your healthcare agent or proxy. Answers to specific questions about your preferences for care if you become unable to speak for yourself. The forms and questions asked vary a bit from state to state.

Advance directives generally fall into three categories: living will, power of attorney and health care proxy. LIVING WILL: This is a written document that specifies what types of medical treatment are desired.

A specific and common example of an advance directive is a do not resuscitate order (or DNR), which guides care only if your heart stops beating (cardiac arrest) or you are no longer breathing.

Making Your Advance Care Wishes Known. There are two main elements in an advance directivea living will and a durable power of attorney for health care. There are also other documents that can supplement your advance directive. You can choose which documents to create, depending on how you want decisions to be made.

Additionally, when you are ready to fill out your advance directive, your health care team might be able to help.The living will.Durable power of attorney for health care/Medical power of attorney.POLST (Physician Orders for Life-Sustaining Treatment)Do not resuscitate (DNR) orders.Organ and tissue donation.

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Part I lets you name. Completing an Advance Directive — Do I need a lawyer to complete an advance directive?State of Ohio Advance Directives: Health Care Power of Attorney. Living Will Declaration. This form is called an Advance Health care Directive. Who can fill out this form? May fill out the Advance Directive form stating your medical preferences even if you do not identify an agent.

Letter Of Directive Form

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