Form sfl 2026

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Click ‘Get Form’ to open the form in the editor.
Select the applicable box for your registration type: New Registration, Amendment, Revocation Only, or Revocation and New Registration. Ensure you check only one box.
If registering a new directive, complete the entire form and prepare a $10.00 fee for submission. For amendments or revocations, fill out Items 3 and 7 only.
Provide your personal information in the Registrant’s section, including your name, address, date of birth, and at least one identifying number (Social Security Number or Driver’s License Number).
If applicable, enter details for your agent and alternate agent who will make health care decisions on your behalf.
Indicate the intended place of deposit for your directive if necessary.
Finally, sign and date the form before submitting it to ensure it is valid.

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