AffirmHealth Resource Library

A Guide to Advance Directives and Advance Care Planning

opioid prescribing resources

Advance Directive Resources

Welcome to the AffirmHealth Resource Library. If you perform Advance Care Planning, easy access to the latest state Advance Directives is a must. We’ve assembled this resource board to help navigate your organization, practice or facility towards the right Advance Directives.

 


 

 

 

 

 

 

 

 

The information presented on or through this website is made available solely for general information purposes and is not intended to substitute for professional, medical or legal advice. We do not warrant the accuracy, completeness, or usefulness of this information. Any reliance you place on such information is strictly at your own risk. We disclaim all liability and responsibility arising from any reliance placed on such materials.

 

Advance Directive Documents & Forms: State-by-State

Select your state

 

ALABAMA

Living Will & Health Care Proxy

Advance Directives

 

ALASKA

Advance Directive

 

ARIZONA

Registration Agreement

Power of Attorney

Mental Health

Living Will

Letter To Representative

DNR

 

ARKANSAS

Surrogate

Advance Care Plan (DNR)

Appointment of Health Care Agent

POLST

 

CALIFORNIA

Form and Instructions

POLST 

 

COLORADO 

MOST

Medical Decisions

Colorado Advance Directives Consortium

  

CONNECTICUT

Appointment of Health Care Rep & Living Will

Appointment of HC rep (SOLO)

MOLST

 

DELAWARE 

DMOST

 

FLORIDA

Living Will

Designation of Health Care Surrogate

Donor Form

POLST

 

GEORGIA

Health Care Agent, Treatment Preferences, Guardianship, Effectiveness and Signatures

POLST

  

HAWAII

POLST

Advance directives example from the University of Hawaii

 

IDAHO

Idaho has an online state health care directive registry. 

Idaho Directive Registry Form

Living Will

  

ILLINOIS

Declaration For Mental Health Treatment Form

Living Will Declaration Form 

POLST

Power of Attorney For Healthcare

  

INDIANA

Healthcare Rep

POST 

Out of Hospital DNR

Life Prolonging Procedures Declaration

Living Will

 

IOWA

Living Will & Med Power of Attorney

IPOST

University of Iowa Advance Directive Resources

  

KANSAS

Transportable Physician Orders for Patient Preferences (TPOPP)

Advance Directive Guides from The University of Kansas School of Law

 

KENTUCKY

Living Will Packet 

MOST

 

LOUISIANA

Living Will Declaration Form

POST

 

MAINE

Maine Health Care Advance Directive Form

 

MARYLAND

AD PACKET (Selection of Health Care Agent, Treatment preferences)

MOLST

 

MASSACHUSETTS

Health Care Proxy

MOLST 

Information about health care proxies, living wills and letting your family know about your preferences for life sustaining medical treatments.

 

MICHIGAN

Patient Advocate Designation & Statement of Wishes 

POST

 

MINNESOTA

Living Will, Health Care Proxy, Wishes

POLST 

 

MISSISSIPPI

Power of Attorney/Agent Designation, Instructions for Health Care

POST

  

MISSOURI

Durable Power of Attorney for Health Care and Health Care Directive

HIPAA Privacy Authorization Form 

TPOPP

 

MONTANA

My Choices AD

POLST 

Montana’s End-of-Life Registry and information about advance directives

  

NEBRASKA

Living Will 

Advance directive information from the University of Nebraska Medical Center

 

NEVADA

POLST 

Living Will and Power of Attorney Information and Forms

 

NEW HAMPSHIRE

New Hampshire Advance Care Planning Guide

  

NEW JERSEY

Proxy Directive

Instructive Directive (Living Will)

POLST 

Advance directive forms and frequently asked questions

 

NEW MEXICO

New Mexico offers extensive information about advance directives and end-of-life planning on a state website called New Mexico Medical Orders for Scope of Treatment (NM MOST).

MOST Form

 

NEW YORK

Health Care Proxy

Non-hospital DNR Order

MOLST

Advance care planning website from the New York Department of Health

 

NORTH CAROLINA

Health Care Power of Attorney

Living Will

Advance Instruction for Mental Health Treatment

MOST 

North Carolina Advance Health Care Directive Registry

 

NORTH DAKOTA

POLST

Download the North Dakota Health Care Directive form from the North Dakota State University Aging Well website.

 

OHIO

Health Care Power of Attorney

Living Will

Donor Registry

 

OKLAHOMA

Living Will & Health Care Proxy 

POLST

 

OREGON

Health Care Rep

POLST 

State of Oregon website for advance directive information and forms

 

PENNSYLVANIA

Advance Directive Forms from Penn Medicine

 

RHODE ISLAND

Living Will

Durable Power of Attorney

Medical Orders for Life-Sustaining Treatment (MOLST)

 

SOUTH CAROLINA

Living Will

Health Care Power of Attorney

POST

Advance directive brochure and information from the state website

 

SOUTH DAKOTA

Living Will

Living will download form from the State Bar of South Dakota

 

TENNESSEE

Advance Directive (Agent, Wishes)

POST

Provider Identification of Surrogate

 

TEXAS

Declaration for Mental Health Treatment

Living Will

Medical Power of Attorney/ Designation of Health Care Agent

Out of Hospital DNR

Statutory Durable Power of Attorney

Texas Health and Human Services advance directive information

 

UTAH

Utah Advance Health Care Directive forms and instructions

 

VERMONT

Advance Directives From Healthvermont.gov

 

VIRGINIA

Virginia Department of Behavioral Health and Developmental Services

 

WASHINGTON

Healthcare directives from End of Life Washington

 

WEST VIRGINIA

Advance directive forms and upload registry at the West Virginia Center for End-of-Life Care

 

WISCONSIN

Living Will

Authorization for Final Disposition

DNR Order

Forms from the Wisconsin Department of Health Services

 

WYOMING

My Choices booklet with form downloads from Wyoming Medical Center