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Form 3 1 advance health care directive 2026
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- Click ‘Get Form’ to open the form in the editor.
- In Part 1, designate your primary agent by filling in their name, address, and contact information. Ensure that this individual is not an employee of your healthcare provider unless they are a relative.
- Optionally, name alternate agents if your primary agent is unavailable. Fill in their details as required.
- Specify the authority of your agent regarding health care decisions. You can add any limitations to their authority in the provided space.
- In Part 2, express your wishes regarding end-of-life decisions by selecting either to prolong life or not. Initial next to your choice.
- Complete any additional instructions for pain relief or other specific wishes in the designated sections.
- If you wish to donate organs upon death, complete Part 3 with your preferences.
- Finally, sign and date the form in Part 5 and ensure it is witnessed appropriately.
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form 3 1 advance healthcare directive
INSTRUCTIONS. Part 1 of this form lets you name another individual as agent to make health care decisions for you if you become incapable of making your ownRead more
Nov 20, 2025 An advance directive is a written document that outlines your wishes for medical treatment in the future, including if you are no longer able to make thoseRead more