What this document does:

• Names a health care agent to make medical decisions for you if you can’t make them yourself.
• Records your wishes for end-of-life care through a Living Will, so your family and doctors know what you want.
• Lets you make a specific do-not-resuscitate (DNR) election if that’s a choice you want documented in advance.

What’s inside:
Three parts: a Living Will section recording your wishes for life-sustaining treatment, artificial nutrition and hydration, and pain management; a Health Care Power of Attorney section naming your agent (and a successor agent if your first choice can’t serve) with the authority to carry out your wishes and make decisions your document doesn’t specifically address; and a Do Not Resuscitate election section, initialed only if you want it, that documents your preference and can authorize your agent to request, sign, or revoke a DNR or POLST order on your behalf. Signature lines for you and the required witnesses.

Before you sign:
Most states require two witnesses, and some also require or accept notarization. Check your state’s specific execution requirements before you sign, they vary more on this document than on most. Give a copy to your named agent and your primary doctor once it’s signed, an advance directive that’s never seen doesn’t help anyone.

Orderly Affairs LLC provides self-help legal document templates. We are not a law firm, we are not your attorney, and using this kit does not create an attorney-client relationship. This is a general template; while a licensed attorney has reviewed it in general form, no attorney has reviewed it for your individual circumstances or your state’s specific requirements. You are responsible for signing, witnessing, and, where applicable, notarizing this document the way your state requires.

Digital Download: Delivered as an instant PDF download after checkout, plus a confirmation email with your download link. This is a print-and-complete document: it does not have interactive fillable form fields, so you print it and fill in the blanks by hand, or open it in PDF or word-processing software to type over the blanks before printing. Available worldwide.

Printed & Shipped: Printed and shipped to you: an Advance Directive Kit on standard paper in a flat mailer. Ships within the continental United States, plus carrier shipping calculated at checkout; international shipping for the printed kit is not currently available (the digital download is).