....Description & form

• Click for Advance Directive
• Click for Worksheet 1 - Values Questionnaire
• Click for Worksheet 2 - Medical Situations and their Treatment
• Click for Checklist Advance Directive
  

To print copies of any of these forms just click the form link, and then click the print option on the form. They are designed to print on 8.5" by 11" paper in portrait layout. Most forms are 2 pages in length.

Advance Directive - This is a legal document that allows you to appoint someone (called your "agent") to make a broad range of health care decisions for you if, for any reason, you become unable to make those decisions for yourself. The Advance Directive can cover any health care situation in which you are incapable of making your own decisions. You can use the Advance Directive to instruct your agent to request all appropriate care or to limit some types of care. Click here to print form.

Worksheet 1 - Values Questionnaire - The questions contained in this worksheet can help you think about your values as they relate to medical care decisions. You may use the questions to discuss your views with your health care agent and others, or you may write answers to the questions as a help to your agent and health care team. Click here to print form.

Worksheet 2 - Medical Situations and their Treatment - This worksheet presents possible treatment plans for a variety of common medical situations. You may use these examples to discuss your views with your health care agent and others, or you may write down your choices as a help to your agent and health care team. Click here to print form.

Checklist for Advance Directive - This sheet contains a list of steps that may be helpful to you as a reminder of things that might be good to check on as you plan and fill out an Advance Directive. Click here to print form.

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