The Arkansas Advance Directive is an all-encompassing document that covers an array of different medical topics. It allows users to determine what the protocol will be for certain life-sustaining treatments as well as the ability to appoint an individual to make decisions on their behalf. To put this into effect, the primary individual will have to designate their agent, specify their wishes and powers that they would like to furnish, and sign the paperwork per state law.
This Document Contains:
Laws
Statutes – Arkansas Code – Arkansas Healthcare Decisions Act (§ 20-6-101 – 20-6-118)
Definitions – “Advance directive” means an individual instruction or a written statement that anticipates and directs the provision of health care for an individual, including without limitation a living will or a durable power of attorney for health care (§ 20-6-102(1)).
Signing Requirements – The principal’s signature must take place in front of a notary public or two (2) qualifying witnesses (§ 20-6-103(c)(1)) and § 20-17-202(a)(3)).
Revocation – § 20-6-104
Other Versions (9)
- AARP (Caring Connections)
- Arkansas Bar Assoc.
- Arkansas Law Help
- Baptist Health
- BRMC Version
- Five Wishes (Aging with Dignity)
- JRMC Version
- Prepare for Your Care
- UA for Medical Sciences Version
AARP (Caring Connections) Version
Download: Adobe PDF
Instructions: Adobe PDF
Arkansas Bar Association Version
Download: Adobe PDF
Download: Adobe PDF
Download: Adobe PDF
Baxter Regional Medical Center Version
Download: Adobe PDF
Information: Adobe PDF
Five Wishes (Aging with Dignity) Version
Download: Adobe PDF
Information: Adobe PDF
Jefferson Regional Medical Center Version
Download: Adobe PDF
Prepare for Your Care Version (also available in Spanish/en Español)
Download: Adobe PDF
University of Arkansas for Medical Sciences Version
Download: Adobe PDF
Information: Adobe PDF
Additional Resources
- Arkansas Dept. of Health – POLST Information
- Arkansas Hospice – Advanced Care Plans
- Baptist Health – Living Will and Advanced Directive
- Christus Health – Advance Care Planning
- Donate Life Arkansas – Become a Donor
- Jefferson Regional Medical Center – Health Care Choices Guide
- University of Arkansas for Medical Sciences – Advance Medical Directives
Related Forms (5)
- Acceptance of Surrogate
- Advance Directive Wallet Card
- Durable (Financial) Power of Attorney Form
- EMS DNR Form
- POLST Form
Download: Adobe PDF
Download: Adobe PDF
Durable (Financial) Power of Attorney
Download: Adobe PDF, MS Word (.docx)
Emergency Medical Services Do-Not-Resuscitate Order
Download: Adobe PDF
Physician Orders for Life-Sustaining Treatment (POLST)
Download: Adobe PDF