Hawaii Advance Directive Form (Medical POA & Living Will)

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Updated on June 12th, 2023

The Hawaii Advance Directive can help residents of the state avoid unwanted medical treatment if they are ever in an incapacitated state. When someone is facing serious health consequences and no longer has the ability to communicate, the burden can sometimes fall on the shoulders of their loved ones to make certain difficult decisions for them. This instrument allows somebody to preemptively declare what their wishes are regarding life-sustaining treatments, pain relief, and overall end-of-life care. After stipulating what is important to them, they may also assign an agent to handle any additional decision-making that may need to occur (this should be someone that is trustworthy and prepared to take on the role).

Other Versions (8)

AARP (Caring Connections) Version

Download: Adobe PDF
Instructions: Adobe PDF

 

 


Catholic Diocese of Honolulu Version

Download: Adobe PDF

 

 

 


Five Wishes (Aging with Dignity) Version

Download: Adobe PDF

 

 

 


Kaiser Permanente Version

Download: Adobe PDF
Instructions: Adobe PDF

 

 


Kōkua Mau Version

Download: Adobe PDF

 

 

 


Lifecare Directives Version

Download: Adobe PDF

 

 

 


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

Download: Adobe PDF

 

 

 


University of Hawaii Version (short form also available)

Download: Adobe PDF
Information & Checklist: Adobe PDF

 

 

Multilingual Versions (10)

Chinese (Simplified) Version

Download: Adobe PDF
Information: Adobe PDF

 

 


Chinese (Traditional) Version

Download: Adobe PDF
Information: Adobe PDF

 

 


Ilocano Version

Download: Adobe PDF
Information: Adobe PDF

 

 


Japanese Version

Download: Adobe PDF
Information: Adobe PDF

 

 


Korean Version

Download: Adobe PDF
Information: Adobe PDF

 

 


Marshallese Version

Download: Adobe PDF
Information: Adobe PDF

 

 


Spanish/Español Version

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Information: Adobe PDF

 

 


Tagalog Version

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Information: Adobe PDF

 

 


Tongan Version

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Information: Adobe PDF

 

 


Vietnamese Version

Download: Adobe PDF
Information: Adobe PDF

 

 

Additional Resources

Related Forms

Advance Directive for Mental Health

Download: Adobe PDF

 

 

 


Durable (Financial) Power of Attorney

Download: Adobe PDF

 

 

 


POLST (Provider Orders for Life-Sustaining Treatment) Form
(§ 327K-1 – § 327K-4)

Download: Adobe PDF
Information: Adobe PDF