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Advance Directive for Health Care Form - Indiana
An Indiana Advance Directive is a revisable set of written instructions about future medical care that take effect in cases when a patient becomes unable to make decisions for themselves. The purpose of the form is to let an individual plan their medical treatment in advance.
Download a pre-made template through the link below or make your own Advance Directive with our online template.
The form lists decisions on life-sustaining medical procedures and about the specific kinds of treatment the individual may or may not wish to receive and can be used to elect a spouse, relative, friend or attorney as a decision-maker in case the individual is unable to make their own decisions because of an illness, accident or incapacity. The main difference between this form and an Indiana Living Will is that a Living Will - also called a "directive to physicians" - is one form of the Advance Health Care Directive. It's more limited in nature and only state a patient's wishes for end-of-life medical care.
An Indiana Advance Directive is regulated by Title 16 (Health) Chapter 4 (Living Wills and Life-Prolonging Procedures) of the Indiana Code . The document must be signed in the presence of at least two (2) witnesses who are at least eighteen (18) years of age.
What Is an Indiana Advance Directive?
An Advance Directive is a document in which an individual states their preferences regarding health care procedures that become effective when they are no longer able to make decisions for themselves. The contents can be updated and changed as often as the individual wishes.
The form includes two parts in total:
- A Living Will - a specific type of Advance Directive which can also be used on its own - is a signed and witnessed document called a "declaration" or "directive" with instructions for an attending physician to withhold or withdraw certain medical interventions once the signer is no longer able to verbally make decisions about medical treatment.
- A Durable Power of Attorney for Health Care - otherwise known as a health care proxy - is a notarized document in which the signer designates an agent to make health-related decisions on their behalf.
How to Write an Advance Directive in Indiana?
Creating an Advance Care Directive in Indiana usually features the following steps:
- Learn the necessary components of the document. Consider including a Living Will to express end-of-life medical preferences. Designate a health care proxy - or agent - using a Health Care Power of Attorney.
- Get the required paperwork and begin filling out your form.
- Determine your wishes on CPR, breathing tubes, feeding tubes, surgeries, kidney dialysis, and organ donation.
- Discuss your wishes with your partner, family, friends and health care providers to make sure your plans are known to them ahead of time.
- Hand copies of the certified and signed form to your health care proxy and doctors. Keep the original in an obvious easy-to-find place with your other paperwork and keep more copies handy.
Download Advance Directive for Health Care Form - Indiana
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