Connecticut Advance Directive Form (Medical POA & Living Will)

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The Connecticut Advance Directive is becoming the norm for individuals documenting their medical wishes ahead of time. It unites the medical power of attorney with the living will,  giving users a blend of both documents. The medical POA portion of the form provides the option of designating a third (3rd) party to make healthcare decisions on your behalf, whereas the living will section allows you to stipulate your own choices. The principal must provide the agent’s name and establish their desires regarding certain medical procedures to put the arrangement into effect. The legal instrument must then be signed under the observation of two (2) witnesses (it is considered a good measure to additionally acquire the certification of a notary public).

Other Versions (6)

Connecticut Advance Directive – Version 1

Download: Adobe PDF

 

 

 


AARP (Caring Connections) Version

Download: Adobe PDF
Instructions: Adobe PDF

 

 


Five Wishes (Aging with Dignity) Version

Download: Adobe PDF
Information: Adobe PDF

 

 


Prepare for Your Care Version (also available in Spanish/en Español)

Download: Adobe PDF

 

 

 


Stamford Health Version (also available in Spanish/en Español)

Download: Adobe PDF
Information: Adobe PDF

 

 


Yale New Haven Health Version (also available in Spanish/en Español)

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Additional Resources

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Durable (Financial) Power of Attorney

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Medical Orders for Life Sustaining Treatment (MOLST) Form

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